Provider Demographics
NPI:1811707367
Name:PRYOR, MARCHELLE
Entity type:Individual
Prefix:
First Name:MARCHELLE
Middle Name:
Last Name:PRYOR
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 1:3737 S STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64052-2363
Mailing Address - Country:US
Mailing Address - Phone:913-208-9921
Mailing Address - Fax:
Practice Address - Street 1:3737 S STERLING AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-2363
Practice Address - Country:US
Practice Address - Phone:913-208-9921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemaker