Provider Demographics
NPI:1376293399
Name:PRATHER, GINGER LYNN
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:LYNN
Last Name:PRATHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11719 HENLEY CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-4101
Mailing Address - Country:US
Mailing Address - Phone:301-412-0469
Mailing Address - Fax:
Practice Address - Street 1:11719 HENLEY CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-4101
Practice Address - Country:US
Practice Address - Phone:301-412-0469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No291U00000XLaboratoriesClinical Medical Laboratory