Individual
MS. TRISTA D PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
701 S PARK AVE, LAS ANIMAS, CO 81054-1575
(719) 456-0517
(719) 456-0518
Mailing address
701 S PARK AVE, LAS ANIMAS, CO 81054-1575
(719) 456-0517
(719) 456-0518
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 197631
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197631
RN LICENSE
CO
Enumeration date
05/02/2012
Last updated
05/21/2013
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