Individual
MRS. KATHRYN CLAIRE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
111 CHASE ST, BYHALIA, MS 38611
(502) 810-4164
Mailing address
8820 TURKEY CREEK DR, OLIVE BRANCH, MS 38654-8096
(502) 810-4164
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19930
TN
363LF0000X
Family Nurse Practitioner
Primary
895684
MS
Other
Enumeration date
06/09/2005
Last updated
07/26/2023
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