Individual
MARK A PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
101 DOCTORS PARK, GALAX, VA 24333-2277
(541) 632-4050
(276) 883-6232
Mailing address
101 DOCTORS PARK, GALAX, VA 24333-2277
(276) 595-8921
(276) 883-6232
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024178316
VA
363L00000X
Nurse Practitioner
7012
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3902626
—
TN
Enumeration date
09/12/2005
Last updated
12/01/2025
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