Individual
GINA MARIE PRUNTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 GRAND CENTRAL MALL, VIENNA, WV 26105-4100
(304) 485-3300
Mailing address
800 GRAND CENTRAL MALL, VIENNA, WV 26105-4100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
107648
WV
Other
Enumeration date
09/15/2018
Last updated
07/23/2021
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