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Individual

BROOKE NICOLE PRUITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
4802 E JOHNSON AVE, JONESBORO, AR 72401-8413
(870) 936-8000
(870) 934-3630
Mailing address
PO BOX 1960, JONESBORO, AR 72403-1960
(870) 936-8000
(870) 934-3630

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A003418
AR
363L00000X
Nurse Practitioner
A03418 ANP
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
185886758
AR
Enumeration date
08/31/2010
Last updated
02/25/2016
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