Provider Demographics
NPI:1477838944
Name:PRATER, RODNEY ALLEN (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:ALLEN
Last Name:PRATER
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6262 WEBER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4030
Mailing Address - Country:US
Mailing Address - Phone:361-850-8300
Mailing Address - Fax:
Practice Address - Street 1:6262 WEBER RD STE 120
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-4030
Practice Address - Country:US
Practice Address - Phone:361-850-8300
Practice Address - Fax:361-850-8302
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX615820363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health