| NPI | 1396274874 |
|---|---|
| Former Name | ELIZABETH PRUITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011257) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011257) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2020-12-14 |