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Individual
GLENDA FAYE PRUITT
Active
Individual
GLENDA FAYE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CFNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
220196
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018845002
—
TX
05
—
167663701
—
TX
Enumeration date
08/16/2006
Last updated
05/20/2011
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