Individual
REGINA D PRUITT
Active
Individual
REGINA D PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.493
AL
363AM0700X
Medical Physician Assistant
Primary
PA9113304
FL
363AS0400X
Surgical Physician Assistant
PA-493
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA575
HF MA
FL
Enumeration date
05/14/2007
Last updated
05/17/2022
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