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Organization
GLENDA PRUITT PC
Active
Organization
GLENDA PRUITT PC
Active
Other names
Strawn Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLENDA F. PRUITT RN CFNP (DIRECTOR)
(254) 672-5200
Entity
Organization
Contact information
Practice address
119 CENTRAL AVE., 119 CENTRAL AVE., STRAWN, TX 76475-0006
(254) 672-5200
Mailing address
PO BOX 6, 119 CENTRAL AVE., STRAWN, TX 76475-0006
(254) 672-5200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
220196
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1676637
—
TX
01
—
1679686257
INDIVIDUAL NPI NUMBER
TX
Enumeration date
01/02/2007
Last updated
08/22/2020
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