Individual
JOY M. PRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
555423
TX
363LF0000X
Family Nurse Practitioner
555423
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP107963
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022717-03
—
TX
01
—
8N9136
BLUE SHIELD
TX
Enumeration date
04/07/2006
Last updated
01/05/2021
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