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Individual
NATHANIEL PRUITT
Active
Individual
NATHANIEL PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
242649
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
GAA-NP004232
GA
Other
Enumeration date
04/19/2024
Last updated
11/24/2025
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