Provider Demographics
NPI:1114199759
Name:PRAY, STEPHEN EARL III (NP)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:EARL
Last Name:PRAY
Suffix:III
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3283 E ORIOLE WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-5669
Mailing Address - Country:US
Mailing Address - Phone:480-897-6535
Mailing Address - Fax:
Practice Address - Street 1:3283 E ORIOLE WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5669
Practice Address - Country:US
Practice Address - Phone:480-897-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2938363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health