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Individual

WHITNEY BONI PRUITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP

Contact information

Practice address
512 VILLAGE RD STE 207, SHALLOTTE, NC 28470-3409
(910) 662-7500
(910) 662-7501
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5017081
NC
363LP2300X
Primary Care Nurse Practitioner
5017081
NC

Other

Enumeration date
10/26/2022
Last updated
04/15/2026
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