Provider Demographics
NPI:1467483834
Name:PRAY, PAMELA A (CNM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:PRAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 ARKANSAS ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1335
Mailing Address - Country:US
Mailing Address - Phone:785-832-1424
Mailing Address - Fax:785-832-1466
Practice Address - Street 1:330 ARKANSAS ST
Practice Address - Street 2:SUITE 330
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1335
Practice Address - Country:US
Practice Address - Phone:785-832-1424
Practice Address - Fax:785-832-1466
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS64094367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200327120GMedicaid
KS110476006Medicare PIN