Provider Demographics
NPI:1699818427
Name:PRYOR-CORDES, LUCIEL (PA-C)
Entity type:Individual
Prefix:
First Name:LUCIEL
Middle Name:
Last Name:PRYOR-CORDES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US HEALTH CLINIC KUWAIT
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09366
Mailing Address - Country:US
Mailing Address - Phone:318-430-1798
Mailing Address - Fax:
Practice Address - Street 1:US HEALTH CLINIC KUWAIT
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09366
Practice Address - Country:US
Practice Address - Phone:318-430-1798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical