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Individual

DOUGLAS PRUITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
6200 N LA CHOLLA BLVD, TUCSON, AZ 85741-3529
(520) 742-9000
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28155497A
IN
367500000X
Certified Registered Nurse Anesthetist
28162626
IN
367500000X
Certified Registered Nurse Anesthetist
326345
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200047710
IN
Enumeration date
05/12/2006
Last updated
10/08/2025
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