Individual
SOFIYA ALEXIS PRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10012 KENNERLY RD STE 102, SAINT LOUIS, MO 63128-2197
(314) 543-5911
(314) 543-5914
Mailing address
10012 KENNERLY RD STE 102, SAINT LOUIS, MO 63128-2197
(314) 543-5911
(314) 543-5914
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2024040291
MO
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
06/16/2026
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