Individual
KODY LEE PRUNTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3423 KELLY ST APT 333, GRAND ISLAND, NE 68803-1326
(308) 930-9219
Mailing address
929 S GREENWICH ST, GRAND ISLAND, NE 68801-6740
(308) 391-7079
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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