Prajnawati Wibowo, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP139122 Issued in TX

Practice address

5301 Alpha Rd Ste 80-3
Dallas, TX 75240-4355

Phone

(682) 215-1691

Fax

(682) 267-4840

NPI assigned

Oct 29, 2018

Last updated

Oct 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, AZ, NY, CA, NM, WA, FL7 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 7

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lucent Home Health LLC Home health agency, Plano, TX, CCN 743191

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grace in Healings PLLC

  • Psychiatric/Mental Health Registered Nurse
  • Dallas, TX
  • NPI 1699557694
  Medicare reassignment NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, NM, NY, Psychiatric/Mental Health, TX, WA

  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  TX

  Medicare reassignment NPD
• Nisha Satish MD PA

  dba Primed Solutions

  • Family Medicine Physician
  • Greenville, TX
  • NPI 1902171226
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lucent Home Health LLC

  dba Lucent Health Group

  • Home Health Agency
  • Plano, TX
  • NPI 1649462334
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1760959696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 ALPHA RD STE 80-3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404355",
            "telephone_number": "682-215-1691",
            "fax_number": "682-267-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 ALPHA RD STE 80-3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404355",
            "telephone_number": "682-215-1691",
            "fax_number": "682-267-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBOWO",
        "first_name": "PRAJNAWATI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP139122",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP139122",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95034910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wholistic Herbs Inc.
• Why Stop Learning, LLC
• Nicole A Whyte, P.T.
• Ocean Yanique Whyte, MSN, APRN, FNP-BC
• Frank Henry Wians Jr., PH.D.
• Sara B. Wick, GNP
• Gena Menzdorf Wickes, D.C.
• Jonathan Eric Wickiser, MD
• Lisa Baker Wicklund, LMFT-A
• Itala Manosha Wickremasinghe, MD

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.