Provider Demographics
NPI:1447034533
Name:PRYCE, SHANICE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHANICE
Middle Name:
Last Name:PRYCE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 N LUMINA LN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-3796
Mailing Address - Country:US
Mailing Address - Phone:347-280-8127
Mailing Address - Fax:
Practice Address - Street 1:992 DURHAM RD STE C
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6590
Practice Address - Country:US
Practice Address - Phone:919-368-8839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018666363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health