Individual
KENNETH DEAN PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
2707 BROWNS LN, JONESBORO, AR 72401-7213
(870) 972-4939
(870) 972-4911
Mailing address
2707 BROWNS LN, JONESBORO, AR 72401-7213
(870) 972-4939
(870) 972-4911
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ATP-000181
AR
Other
Enumeration date
04/10/2007
Last updated
04/12/2011
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