MEDICARE: MRS. NADIA HAMDANI PRUETT RN, MSN, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	739131	TX
2	363LF0000X	Family Nurse Practitioner	AP125187	TX

General Provider Information

NPI Number	:	1528478088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NADIA HAMDANI PRUETT RN, MSN, FNP

Provider Business Mailing Address
First Line	:	2450 HOLCOMBE BLVD STE NB-34L
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-2039
Country	:	US
Telephone Number	:	832-828-3660
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 HOLCOMBE BLVD STE NB-34L
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-2039
Country	:	US
Telephone Number	:	832-828-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2014
Last Update Date	:	03/17/2018

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