| Doctor Name: | JESSICA PRUITT |
| NPI Number: | 1093112047 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 5703 |
| Business Practice Address: | 222 Sequoyah Rd Soddy Daisy, TN - 373795154 |
| Business Phone Number: | 4233320979 |
| Business Fax Number: | |
| Mailing Address: | 222 Sequoyah Rd, SODDY DAISY |
| State: | TN |
| Postal Code: | 373795154 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2014 |
| NPI Last Update Date: | 11/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174M00000X |
| License Number: | 5703 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Veterinarian |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |