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Individual

NATHANIEL PRUITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1575 CHATTANOOGA AVE STE 1, DALTON, GA 30720-2672
(706) 876-2130
Mailing address
1608 LEE ST SE, CLEVELAND, TN 37311-3273

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
242649
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
GAA-NP004232
GA

Other

Enumeration date
04/19/2024
Last updated
11/24/2025
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