Individual
KELLIE M PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4491
(419) 479-6905
Mailing address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4491
(419) 479-6905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA13988NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075110
—
OH
Enumeration date
10/29/2012
Last updated
12/05/2014
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