Provider Demographics
NPI:1447988191
Name:PRESCOTT, DANICE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DANICE
Middle Name:
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-1752
Mailing Address - Country:US
Mailing Address - Phone:270-227-1105
Mailing Address - Fax:
Practice Address - Street 1:1705 OLIVE ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1752
Practice Address - Country:US
Practice Address - Phone:270-227-1105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2022043557363LP0808X
KY3018203363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health