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1400 N Coit Rd Ste 302 Mckinney TX 75071-6656 | |
| (972) 987-6183 | |
| (972) 987-6184 |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1400 N Coit Rd Ste 302, Mckinney, Texas |
| Authorized Official Name and Position | Carnika Donald (CEO) |
| Authorized Official Contact | 9729876183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
251 Wilson Dr Prosper TX 75078-8583 Ph: (504) 905-3417 | 1400 N Coit Rd Ste 302 Mckinney TX 75071-6656 Ph: (972) 987-6183 |
| NPI Number | 1467819029 |
|---|---|
| Provider Enumeration Date | 01/26/2016 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 5698074144 |
|---|---|
| Medicare Enrollment ID | O20160504001791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467819029 | NPI | - | NPPES |
| 489032 | Other | TX | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Carnika S Donald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295111367 PECOS PAC ID: 7315248796 Enrollment ID: I20151209002516 |
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