Mary Jane Prysock, RN, BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

12013 Issued in WY

Practice address

510 W 29TH St
Cheyenne, WY 82001-2760

Phone

(307) 632-9362

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215044078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W 29TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012760",
            "telephone_number": "307-426-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W 29TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012760",
            "telephone_number": "307-632-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYSOCK",
        "first_name": "MARY",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WY",
            "license": "12031",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WY",
            "license": "12013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Registered Nurse in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.