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Individual

MAGGIE MARIE PRUNTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1026 7TH ST W, SAINT PAUL, MN 55102-3828
(651) 758-9500
(651) 241-1058
Mailing address
1026 7TH ST W, SAINT PAUL, MN 55102-3828
(516) 758-9500

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2288448
MN
163W00000X
Registered Nurse
28238096A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
6730
MN

Other

Enumeration date
04/07/2019
Last updated
09/16/2021
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