Individual
LACEY DANIEL PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3603 MARYS VIEW LN, DACULA, GA 30019-1616
(678) 852-8707
Mailing address
3603 MARYS VIEW LN, DACULA, GA 30019-1616
(678) 852-8707
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN230950
GA
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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