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Individual

KYLE PRUETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
701 DELLWOOD ST S, CAMBRIDGE, MN 55008-1920
(763) 689-7700
Mailing address
1502 15TH ST N, PRINCETON, MN 55371-1080

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2365578
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2743
MN

Other

Enumeration date
08/04/2022
Last updated
11/17/2022
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