Provider Demographics
NPI:1275529950
Name:PRYOR, LINDA ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:PRYOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANNE
Other - Last Name:PRYOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN FNP
Mailing Address - Street 1:1020 7TH NORTH ST
Mailing Address - Street 2:STE 220
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-6192
Mailing Address - Country:US
Mailing Address - Phone:315-451-3906
Mailing Address - Fax:315-451-8913
Practice Address - Street 1:1020 7TH NORTH ST
Practice Address - Street 2:STE 220
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-6192
Practice Address - Country:US
Practice Address - Phone:315-451-3906
Practice Address - Fax:315-451-8913
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333041 1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMP0564181OtherDEA