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Individual

DEWAYNE PRUITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
2153 JENKINS ROAD, ALICEVILLE, AL 35442
(205) 367-1619
(205) 367-1619
Mailing address
2111 JENKINS RD, ALICEVILLE, AL 35442-4931
(205) 367-1619
(205) 367-1619

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
1-121419
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000000000
DONT HAVE ONE
AL
Enumeration date
02/18/2022
Last updated
07/21/2022
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