Individual
JORDAN PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1439 JESSE JEWELL PKWY NE STE 302, GAINESVILLE, GA 30501-3806
(770) 219-9200
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13282
GA
Other
Enumeration date
05/12/2025
Last updated
07/29/2025
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