Provider Demographics
NPI:1114600764
Name:PRATHER, NASHELLA WYNEE (APRN)
Entity type:Individual
Prefix:
First Name:NASHELLA
Middle Name:WYNEE
Last Name:PRATHER
Suffix:
Gender:F
Credentials:APRN
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 1:350 N HUMPHREYS BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2177
Mailing Address - Country:US
Mailing Address - Phone:901-226-4003
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:200 STATE HIGHWAY 30 W STE 100
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-3112
Practice Address - Country:US
Practice Address - Phone:662-538-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily