Provider Demographics
NPI:1558765131
Name:PRESTWICH, DAVID (FNPBC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:PRESTWICH
Suffix:
Gender:M
Credentials:FNPBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 BRIDGES ST STE A
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2944
Mailing Address - Country:US
Mailing Address - Phone:252-622-4033
Mailing Address - Fax:522-403-5862
Practice Address - Street 1:3722 BRIDGES ST STE A
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2944
Practice Address - Country:US
Practice Address - Phone:252-622-4033
Practice Address - Fax:252-240-3586
Is Sole Proprietor?:No
Enumeration Date:2014-10-10
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR882894363LF0000X
WAAP60642226363LF0000X
NC5012543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily