Provider Demographics
NPI:1013038298
Name:PRUITT, ROSANNE HARKEY (PHD, APRN,BC)
Entity Type:Individual
Prefix:DR
First Name:ROSANNE
Middle Name:HARKEY
Last Name:PRUITT
Suffix:
Gender:F
Credentials:PHD, APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CARTER HALL DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1976
Mailing Address - Country:US
Mailing Address - Phone:864-656-5528
Mailing Address - Fax:864-656-5488
Practice Address - Street 1:SULLIVAN CTR
Practice Address - Street 2:106 EDWARDS HALL
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29634-0001
Practice Address - Country:US
Practice Address - Phone:864-656-5528
Practice Address - Fax:864-656-5488
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN F824363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner