Provider Demographics
NPI:1114600764
Name:PRATHER, NASHELLA WYNEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:NASHELLA
Middle Name:WYNEE
Last Name:PRATHER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:NASHELLA
Other - Middle Name:WYNEE
Other - Last Name:PRATHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:1005 CITY AVE N
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-1414
Mailing Address - Country:US
Mailing Address - Phone:662-837-2278
Mailing Address - Fax:662-837-2110
Practice Address - Street 1:1005 CITY AVE N
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-1414
Practice Address - Country:US
Practice Address - Phone:662-837-2202
Practice Address - Fax:662-837-2204
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSF07231417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily