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Organization

LIGHTHOUSE HEALTH CLINIC

Active
Other names
Lighthouse Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LINDA S. DONOVAN CPNP (PEDIATRIC NURSE PRACTITIONER)
(512) 528-9996
Entity
Organization

Contact information

Practice address
601 E WHITESTONE BLVD, SUITE 308, CEDAR PARK, TX 78613-9015
(512) 528-9996
(512) 528-9070
Mailing address
601 E WHITESTONE BLVD, SUITE 308, CEDAR PARK, TX 78613-9015
(512) 528-9996
(512) 528-9070

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
629991
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02468
PRESCRIPTIVE AUTHORITY #
TX
01
629991
ADVANCED PRACTICE NURSE
TX
01
98261
NATIONAL CERTIFICATION PN
TX
Enumeration date
02/26/2007
Last updated
04/05/2010
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