Provider Demographics
NPI:1386024925
Name:PRYCE, BLOSSOM (RN)
Entity Type:Individual
Prefix:MS
First Name:BLOSSOM
Middle Name:
Last Name:PRYCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WIMBLEDON COURT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607
Mailing Address - Country:US
Mailing Address - Phone:914-907-3930
Mailing Address - Fax:
Practice Address - Street 1:1 WIMBLEDON CT
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1632
Practice Address - Country:US
Practice Address - Phone:914-907-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420960-1163WH0200X, 163WM0705X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care