Provider Demographics
NPI:1861286825
Name:PRATHER, MARTIESA DAWN
Entity type:Individual
Prefix:
First Name:MARTIESA
Middle Name:DAWN
Last Name:PRATHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 S FREEDOM AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4902
Mailing Address - Country:US
Mailing Address - Phone:330-428-2849
Mailing Address - Fax:
Practice Address - Street 1:2033 S FREEDOM AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4902
Practice Address - Country:US
Practice Address - Phone:330-428-2849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker