MEDICARE: PRISCILLA PAGE FNP-C

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	363LF0000X	Family Nurse Practitioner	AP133282	TX

General Provider Information

NPI Number	:	1689196412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA PAGE FNP-C

Provider Business Mailing Address
First Line	:	3409 WORTH ST STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2042
Country	:	US
Telephone Number	:	469-800-7180
Fax Number	:

Provider Business Practice Location Address
First Line	:	3409 WORTH ST STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2042
Country	:	US
Telephone Number	:	469-800-7180
Fax Number	:	469-800-7190

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

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	02/14/2023

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Directions to “ PRISCILLA PAGE FNP-C” Practice Location

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