Provider Demographics
NPI:1215579693
Name:CEPEDA, PRISCILLA (FNP-C)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:CEPEDA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 PAIGE RD STE D
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2143
Mailing Address - Country:US
Mailing Address - Phone:214-449-0274
Mailing Address - Fax:
Practice Address - Street 1:5910 PAIGE RD
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2141
Practice Address - Country:US
Practice Address - Phone:214-449-0274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily