MEDICARE: JOYCY PRANABDEV

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	R0076371	OK
2	363L00000X	Nurse Practitioner	214477	OK
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	214477	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194429829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCY PRANABDEV

Provider Business Mailing Address
First Line	:	2606 E HIGHWAY 66
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-9611
Country	:	US
Telephone Number	:	580-210-9366
Fax Number	:	580-245-6457

Provider Business Practice Location Address
First Line	:	100 S MONROE ST STE 15
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-5762
Country	:	US
Telephone Number	:	580-210-9396
Fax Number	:	580-245-6457

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	01/06/2026

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Directions to “ JOYCY PRANABDEV ” Practice Location

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