PRAJNAWATI WIBOWO (NPI# 1760959696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760959696 |
| Entity Type | Individual |
| Full Name | PRAJNAWATI WIBOWO |
| Credential | NP |
| Practice Address |
3535 S Interstate 35 E Denton TX 76210-6850 |
| Mailing Address |
8909 Harvest Moon Trl Denton TX 76210-7174 |
| Practice Telephone | 9403843535 |
| Mailing Telephone | 9728558875 |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP139122 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3535 S INTERSTATE 35 E |
| City | DENTON |
| State | TX |
| Zip Code | 76210-6850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477530871 | Mary Charlene Berg | Nurse Anesthetist, Certified Registered | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2005-12-27 |
| 1073084679 | Taylor Fletcher | Physician Assistant | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2018-12-09 |
| 1104367168 | Terrie Branson | Nurse Practitioner | 3535 S Interstate 35 E, Denton, TX 76210 | 2017-03-10 |
| 1649512591 | Ashley Rena Wiles | Nurse Practitioner | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2013-03-19 |
| 1093975278 | Elango Packirisamy Vinjirayer | Internal Medicine | 3535 S Interstate 35 E, Denton Regional Medical Center, Denton, TX 76210-6850 | 2008-06-11 |
| 1952529828 | Justin Robert Northeim | Emergency Medicine | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2007-04-23 |
| 1376769026 | Thomas J Olmsted | Emergency Medicine | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2007-04-18 |
| 1396865358 | Christina K Sokolowski | Physical Therapist | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2007-03-30 |
| 1568545663 | Bradley Ray Armstrong | Physician Assistant | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2006-10-23 |
| 1487621306 | Lise Amy Labiche | Psychiatry & Neurology | 3535 S Interstate 35 E, Denton, TX 76210-6850 | 2006-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609403716 | Corinth Community Pharmacy, LLC. | Pharmacy | 3001 F.m. 2181, Suite 450, Corinth, TX 76210 | 2020-03-26 |
| 1003467200 | Stephanie R Rynor I | Nurse Practitioner | 3001 Fm 2181 Ste 300, Corinth, TX 76210 | 2019-09-28 |
| 1417435389 | Ikids Pediatric Dentistry Denton, Pllc | Dentist | 1212 Bent Oaks Ct Ste 100, Denton, TX 76210 | 2018-08-02 |
| 1083100101 | Ahir Dental Pllc | Dentist | 3220 Teasley Ln, Suite#100, Dention, TX 76210 | 2018-07-02 |
| 1235636010 | Diane Michelle Dean | Counselor | 2701 Shoreline Drive, Denton, TX 76210 | 2018-04-09 |
| 1740709344 | Southridge Dental, LLC | Dentist | 3303 Unicorn Lake Blvd, Ste 200, Denton, TX 76210 | 2017-09-14 |
| 1356876601 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1101 Fm 2181, Corinth, TX 76210 | 2017-04-25 |
| 1366990137 | Phee Dental Group | Dentist | 4920 Teasley Ln, Denton, TX 76210 | 2016-09-21 |
| 1265893283 | Ann Marie Norris | Respiratory Therapist, Registered | 3535 E I-35, Denton, TX 76210 | 2016-03-18 |
| 1447644778 | Santa Patricia Espinoza | Nurse Practitioner | 3537 South Interstate 35e, Ste. 210, Denton, TX 76210 | 2015-03-25 |
| Find all providers in zip 76210 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679082903 | Brandon Morgan Olinger | Nurse Practitioner | 3535 S I 35 E, Denton, TX 76210-6850 | 2017-09-29 |
| 1326321936 | Jamie Michelle Simpson | Nurse Practitioner | 2900 N Interstate 35 Ste 300, Denton, TX 76201-5146 | 2011-09-21 |
| 1871105783 | Amber Parman | Nurse Practitioner | 3535 S I 35 E, Denton, TX 76210-6850 | 2020-08-21 |
| 1003437716 | Jessie Rulan Sherrard | Nurse Practitioner | 3537 S I 35 E Ste 305, Denton, TX 76210-6803 | 2020-05-04 |
| 1427690171 | Sara Elizabeth Darby | Nurse Practitioner | 3322 Colorado Blvd Ste 101, Denton, TX 76210-6889 | 2019-10-15 |
| 1104367168 | Terrie Branson | Nurse Practitioner | 3535 S Interstate 35 E, Denton, TX 76210 | 2017-03-10 |
| 1720499726 | Sarah G Moyo | Nurse Practitioner | 3000 N Interstate 35, Denton, TX 76201 | 2014-05-13 |
| 1639171374 | Terri A. Mcdaniel | Nurse Practitioner | 3333 Colorado Blvd, Denton, TX 76210-6817 | 2005-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215800 | Kellie Lynn Myers | Nurse Practitioner | 26015 Penguin St, Magnolia, TX 77355-6249 | 2020-11-06 |
| 1356942148 | Nina Nicole Totanes | Nurse Practitioner | 12709 Toepperwein Rd Ste 203, Live Oak, TX 78233-3259 | 2020-11-06 |
| 1841890415 | Glenda Kelley | Nurse Practitioner | 8902 W State Highway 56, Savoy, TX 75479-3460 | 2020-10-31 |
| 1184223786 | Vincy Saji Mathew | Nurse Practitioner | 8804 Viridian Ln, Fort Worth, TX 76123-4030 | 2020-10-23 |
| 1265030787 | Lissa Flory | Nurse Practitioner | 4679 Dreibrodt Rd, San Marcos, TX 78666-3388 | 2020-10-16 |
| 1235737941 | Barton Skinner | Nurse Practitioner | 17806 W I-10, Suite 300, San Antonio, TX 78257 | 2020-10-14 |
| 1972101897 | Biny Sam George | Nurse Practitioner | 7207 Baitland Dr, Missouri City, TX 77459-2035 | 2020-10-13 |
| 1285231282 | Nkechi I Carter | Nurse Practitioner | 1550 Katy Gap Rd Apt 1406, Katy, TX 77494-5878 | 2020-10-03 |
| 1770190753 | Julius Osabor Obianke | Nurse Practitioner | 1000 Fallon Dr, Mckinney, TX 75071-1210 | 2020-09-24 |
| 1740896315 | Mackenzie Brooks Jackson | Nurse Practitioner | 46 N Creekside Ct, Houston, TX 77055-7540 | 2020-09-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.