Individual
MOLLY C PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12130 HERMESA COLINA AVE, LAS VEGAS, NV 89138-1137
(612) 207-2801
Mailing address
12130 HERMESA COLINA AVE, LAS VEGAS, NV 89138-1137
(612) 207-2801
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20591
CA
363LF0000X
Family Nurse Practitioner
Primary
814191
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0598623
—
IA
05
—
286995100
—
MN
05
—
4306939
—
MT
01
—
B691
CHAMPUS
—
Enumeration date
10/19/2006
Last updated
05/26/2026
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