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Individual
RUBY BLUE PRUITT
Active
Individual
RUBY BLUE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
MA066909
PA
363A00000X
Physician Assistant
Primary
MA066909
PA
Other
Enumeration date
08/13/2025
Last updated
09/24/2025
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