MEDICARE: GINA LOU PRITCHARD NP

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	363LA2100X	Acute Care Nurse Practitioner	548278	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851382741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA LOU PRITCHARD NP

Provider Business Mailing Address
First Line	:	127 GILMER ST
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2757
Country	:	US
Telephone Number	:	888-747-0202
Fax Number	:	855-758-9784

Provider Business Practice Location Address
First Line	:	1216 CHURCH ST
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2108
Country	:	US
Telephone Number	:	903-885-3059
Fax Number	:	903-885-8539

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	11/03/2015

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