Provider Demographics
NPI:1861827941
Name:PRYTULA, RACHEL W (CRNP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:W
Last Name:PRYTULA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:W
Other - Last Name:TATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:287 HEALTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2031
Mailing Address - Country:US
Mailing Address - Phone:334-792-9500
Mailing Address - Fax:334-793-1815
Practice Address - Street 1:287 HEALTHWEST DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2031
Practice Address - Country:US
Practice Address - Phone:334-792-9500
Practice Address - Fax:334-793-1815
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-110591363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care