Individual
DR. JESSICA S PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(757) 314-7900
(757) 314-7764
Mailing address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202206205
VA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
0202206205
VA
Other
Enumeration date
08/10/2010
Last updated
06/13/2016
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