Provider Demographics
NPI:1447564711
Name:PRATT, PINKY BENNETT III (APRN, FNP-BC, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:PINKY
Middle Name:BENNETT
Last Name:PRATT
Suffix:III
Gender:M
Credentials:APRN, FNP-BC, FNP-C
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Mailing Address - Street 1:205 W WINDCREST ST
Mailing Address - Street 2:STE 130
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4478
Mailing Address - Country:US
Mailing Address - Phone:214-649-5908
Mailing Address - Fax:972-416-9238
Practice Address - Street 1:1020 S STATE HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4471
Practice Address - Country:US
Practice Address - Phone:830-990-4453
Practice Address - Fax:830-990-1892
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2016-07-28
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Provider Licenses
StateLicense IDTaxonomies
TX695742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily