Individual
KELLEY PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 PEACHTREE RD NE STE 575, ATLANTA, GA 30309-1476
(404) 350-0106
Mailing address
781 COURTENAY DR NE, ATLANTA, GA 30306-3458
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
188495
GA
Other
Enumeration date
06/25/2019
Last updated
09/09/2020
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