Provider Demographics
NPI:1871581082
Name:AUSTIN, DONNA KAYE (FNP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:KAYE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:KAYE
Other - Last Name:CHIPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 746079
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8840 BENBROOK BLVD
Practice Address - Street 2:STE 101
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76126-2173
Practice Address - Country:US
Practice Address - Phone:817-813-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129704363LF0000X, 207Q00000X
TNRN111128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3648223Medicaid
Q34657Medicare UPIN
TN3648223Medicaid
TNQ34657Medicare UPIN
TN3648223Medicare PIN
TN3648223Medicare UPIN