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1134439177
JAMIE R PRUITT
URBANA, IL
NPI
1134439177
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Former Name
JAMIE M RAYBURN PRUITT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209008322)
Enumeration Date
2010-10-08
Last Update Date
2014-05-09
Business Address
-- JAMIE R PRUITT NP
611 W. PARK ST. OB/GYN
URBANA, IL 61801-2500
Phone number: 217-383-3140
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Mailing Address
-- JAMIE R PRUITT NP
611 W. PARK ST. BWPC
URBANA, IL 61801-2500
Phone number: 217-383-6792
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