Provider Demographics
NPI:1548362510
Name:PRESCOTT, SUSAN ROBIN (FNP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ROBIN
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:19051 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-2803
Mailing Address - Country:US
Mailing Address - Phone:210-617-5300
Mailing Address - Fax:210-617-5166
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:1D IMC
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:210-617-5166
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX500605363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily