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NPI Code Detail

MEDICARE: JESSE PRITCHETT PMHNP

MEDICARE: JESSE PRITCHETT PMHNP
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
1163W00000XRegistered Nurse882685TX
2363LP0808XPsychiatric/Mental Health Nurse Practitioner283320AZ
3363LP0808XPsychiatric/Mental Health Nurse Practitioner1071648TX

General Provider Information

NPI Number : 1871240721
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE PRITCHETT PMHNP
Provider Business Mailing Address
First Line : 106 E OVILLA RD
Second Line : STE 1A #162
City : RED OAK
State : TX
Zip : 75154
Country : US
Telephone Number : 469-383-8795
Fax Number : 469-242-9679
Provider Business Practice Location Address
First Line : 4245 N CENTRAL EXPY STE 490
Second Line :
City : DALLAS
State : TX
Zip : 75205-4231
Country : US
Telephone Number : 469-383-8795
Fax Number : 469-242-9679
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2022
Last Update Date : 07/16/2025

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