Individual
LISA ROSCHELLE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1210 W BRAKER LN, AUSTIN, TX 78758-3801
(512) 978-8613
(512) 978-8613
Mailing address
1210 W BRAKER LN, AUSTIN, TX 78758-3801
(512) 978-8613
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
703172
TX
163WW0101X
Ambulatory Women's Health Care Registered Nurse
703172
TX
171M00000X
Case Manager/Care Coordinator
703172
TX
Other
Enumeration date
05/19/2025
Last updated
06/13/2025
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