Individual
GABRIELLE PRUCHNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3533 S ALAMEDA ST, CORPUS CHRISTI, TX 78411-1721
(361) 694-5000
Mailing address
3533 S ALAMEDA ST, CORPUS CHRISTI, TX 78411-1721
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2014024678
MO
133V00000X
Registered Dietitian
Primary
DT83559
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014024678
LICENSED DIETITIAN
MO
01
—
DT83559
LICENSED DIETITIAN
TX
Enumeration date
02/17/2015
Last updated
02/17/2015
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