Individual
DR. BIANCA PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,MSN,DNP,CCM
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041490826
IL
163WC0400X
Case Management Registered Nurse
Primary
041490826
IL
163WC1600X
Continuing Education/Staff Development Registered Nurse
041490826
IL
171M00000X
Case Manager/Care Coordinator
4249170
IL
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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