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Individual

ELLEN DONNELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMH- NP

Contact information

Practice address
9525 KATY FWY, SUITE 312, HOUSTON, TX 77024-1407
(713) 463-9449
(716) 463-7181
Mailing address
9525 KATY FWY, SUITE 312, HOUSTON, TX 77024-1407
(713) 463-9449
(716) 463-7181

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
654876
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10041922
AMERIGROUP
TX
01
8N7077
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/26/2007
Last updated
07/08/2007
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