Individual
JESSICA PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2539 VIKING DR STE 101, BOSSIER CITY, LA 71111-2165
(318) 747-8100
(318) 747-8150
Mailing address
2539 VIKING DR STE 101, BOSSIER CITY, LA 71111-2165
(318) 747-8100
(318) 747-8150
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
239904
LA
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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