Individual
LISA CAROL PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1290 ATHENS ST, GAINESVILLE, GA 30507-7000
(770) 531-5641
Mailing address
306 SMOKERISE DR, SAUTEE NACOOCHEE, GA 30571-3223
(706) 865-0466
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN023340
GA
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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