Timothy O Pruett FNP

NPI 1972645117 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1972645117
Gender Male
Enumeration Date 02/13/2007
Last Updated 07/14/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
SUITE 3600
SPRINGFIELD MO, 65804-2265, US
Phone (417) 820-3911
Fax (417) 820-3924
Business Location
PO BOX 2580
SPRINGFIELD MO, 65801-2580, US
Phone (417) 829-4620
Fax (417) 829-4316
Taxonomy Code 363L00000X
License State Missouri
License Number 112446
Remove 1972645117 NPI Number

According to our database, Timothy O Pruett FNP NPI is 1972645117, taxonomy code is 363L00000X and license number is 112446, license state is located at Missouri. Timothy O Pruett FNP physically located at 1900 S National Ave, Springfield MO, 65804-2265. NPI Number Timothy O Pruett FNP has the Individual type.

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1972645117 NPI number is provided on an as is basis without warranty of any kind. 1972645117 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy O Pruett FNP are for informational purposes only.