Pruitt, Glenda Faye

Pruitt, Glenda Faye is an individual health care provider with primary practice located at 2505 Jane Ln , Arlington TX 76001-5519. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Pruitt, Glenda Faye can be contacted via phone (817) 713-9849.

Contact Information

Primary practice address
2505 Jane Ln Arlington TX 76001-5519
Phone: (817) 713-9849
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 220196 Texas

Profile Details

NPI number 1679686257
LBN Legal business name Pruitt, Glenda Faye
Credentials RN CFNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated May 20th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679686257 NPPES
Texas MEDICAID 018845002
Texas MEDICAID 167663701

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