Provider Demographics
NPI:1720332307
Name:PRYOR, VERNA SIMEONE (NP)
Entity Type:Individual
Prefix:MRS
First Name:VERNA
Middle Name:SIMEONE
Last Name:PRYOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 CALLE ROCHELLE
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-6938
Mailing Address - Country:US
Mailing Address - Phone:805-553-1908
Mailing Address - Fax:
Practice Address - Street 1:1683 CALLE ROCHELLE
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6938
Practice Address - Country:US
Practice Address - Phone:805-553-1908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21831363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health