Pruitt, Kelli Elizabeth

Pruitt, Kelli Elizabeth is an sole proprietor health care provider with primary practice located at 2969 Curran Dr N , Jackson MS 39216-4121. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Pruitt, Kelli Elizabeth can be contacted via phone (601) 540-5598.

Contact Information

Primary practice address
2969 Curran Dr N Jackson MS 39216-4121
Phone: (601) 540-5598
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN11007306 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN11007306 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R883741 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP61401686 Washington
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 10006919 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R883741 Mississippi

Profile Details

NPI number 1285049254
LBN Legal business name Pruitt, Kelli Elizabeth
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2014
Last updated May 31st, 2023 - about 3 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 1285049254 NPPES
Mississippi MEDICAID 07407051

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