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Individual

DR. JESSE NATHANIEL PRUITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
904 AUTUMN RD STE 275, LITTLE ROCK, AR 72211-3745
(501) 224-3499
(501) 224-3499
Mailing address
904 AUTUMN RD STE 275, LITTLE ROCK, AR 72211-3745
(501) 224-3499
(501) 224-1140

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD15030
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PD15030
AR PHARMACIST LICENSE
AR
Enumeration date
04/18/2022
Last updated
07/04/2023
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