Provider Demographics
NPI:1417422718
Name:ESCUIN, SALLY (FNP-C)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:ESCUIN
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 1:1975 ALPHA DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-4951
Mailing Address - Country:US
Mailing Address - Phone:469-800-2100
Mailing Address - Fax:
Practice Address - Street 1:1975 ALPHA DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4951
Practice Address - Country:US
Practice Address - Phone:469-800-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF09181524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily