Individual
KEVIN PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5016 COPPER CREEK RD, BELLEVUE, NE 68157-2906
(402) 444-3368
Mailing address
900 S 74TH PLZ, SUITE 200, OMAHA, NE 68114-4675
(402) 444-4679
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
64305
NE
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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