Individual
JACKIE LEIGH PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
166 WESTVIEW DR, GUN BARREL CITY, TX 75156-3508
(903) 910-7804
Mailing address
166 WESTVIEW DR, GUN BARREL CITY, TX 75156-3508
(903) 910-7804
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
TX
Other
Enumeration date
10/08/2024
Last updated
07/07/2025
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