Healthcare Provider Details

I. General information

NPI: 1902129380
Provider Name (Legal Business Name): KARLENE PRYCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2010
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WYNDMONT WAY
COVINGTON GA
30014-7900
US

IV. Provider business mailing address

105 WYNDMONT WAY
COVINGTON GA
30014-7900
US

V. Phone/Fax

Practice location:
  • Phone: 347-595-3177
  • Fax:
Mailing address:
  • Phone: 347-595-3177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN245240
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: