Individual
STACEY LYN PRYCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322
(404) 712-2000
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-2000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209005472
IL
367500000X
Certified Registered Nurse Anesthetist
470426417
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
RN143702
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638884
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/22/2005
Last updated
03/28/2019
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