Prajnawati Wibowo is a Dallas, Texas based nurse practitioner with 7 years of experience in Acute Care. She completed her graduation in 2018. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Prajnawati Wibowo is AP139122 for Psych/Mental Health in Texas. Her current practice location is 5301 Alpha Rd Ste 80-3, Dallas. Patients can reach her at 682-215-1691 or can fax her at 682-267-4840. Prajnawati Wibowo is NP with specialization in Acute Care and her NPI number (Unique professional ID assigned by NPPES) is 1760959696. Prajnawati Wibowo is a licensed independent practitioner and may autonomously provide care. She provides advanced nursing care across the continuum of health care services to meet the specialized physiologic and psychological needs of patients with acute, critical, and/or complex chronic health conditions. This care is continuous and comprehensive and may be provided in any setting where the patient may be found.
Complete Profile:
Prajnawati Wibowo speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
2264862077
Enrollment ID:
I20200420000147
NPI Number:
1760959696
NPI Enumeration Date:
29 Oct, 2018
NPI Last Update On:
21 Feb, 2024
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Prajnawati Wibowo are as mentioned below.
License Number
Specialization
State
Status
AP139122
Psych/Mental Health
Texas
Primary
AP139122
Acute Care
Texas
Secondary
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Prajnawati Wibowo is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Satish Narayan Md Pa (7113086018)
10
Other Medical Identifiers:
Other legacy medical identifiers associated with Prajnawati Wibowo such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
AP139122
Other
Texas
LICENSE
XW5044653
Other
Texas
DATA 2000 WAIVER
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.