Healthcare Provider Details

I. General information

NPI: 1942114103
Provider Name (Legal Business Name): KATIE LYNN PRYOR MED, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N 5TH ST
GREENFIELD OH
45123-1373
US

IV. Provider business mailing address

200 N 5TH ST
GREENFIELD OH
45123-1373
US

V. Phone/Fax

Practice location:
  • Phone: 937-981-3860
  • Fax:
Mailing address:
  • Phone: 937-981-3860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.329741
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: