Healthcare Provider Details

I. General information

NPI: 1073368320
Provider Name (Legal Business Name): JOY ANNA PRYOR PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2024
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-2141 FORT WEAVER RD
EWA BEACH HI
96706-1993
US

IV. Provider business mailing address

6751 N SUNSET BLVD STE 320
GLENDALE AZ
85305-3155
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-3000
  • Fax:
Mailing address:
  • Phone: 602-535-7143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number261560
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5378
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: