Provider Demographics
NPI:1801178611
Name:PRYOR, DOVIE CHRISTINE (RNFA)
Entity Type:Individual
Prefix:
First Name:DOVIE
Middle Name:CHRISTINE
Last Name:PRYOR
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 AUTUMN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6611
Mailing Address - Country:US
Mailing Address - Phone:901-603-3119
Mailing Address - Fax:
Practice Address - Street 1:6105 AUTUMN OAKS DR
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-6611
Practice Address - Country:US
Practice Address - Phone:901-603-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR875625163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant