Provider Demographics
NPI:1073221628
Name:PRYOR, STEPHANIE CHAPPELL (DNP)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:CHAPPELL
Last Name:PRYOR
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:NICOLE
Other - Last Name:CHAPPELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9803 W 89TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4736
Mailing Address - Country:US
Mailing Address - Phone:913-530-4890
Mailing Address - Fax:
Practice Address - Street 1:200 MAINE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1368
Practice Address - Country:US
Practice Address - Phone:785-843-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS81343207Q00000X
KS53-81343-062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty