Individual
ELIZABETH PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 WASHINGTON ST, SAN DIEGO, CA 92103-2289
(619) 260-8300
Mailing address
4835 NIAGARA AVE APT 5, SAN DIEGO, CA 92107-6108
(864) 641-8977
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95030919
CA
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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