Individual provider · Type 1 NPI

Roseann Pruitt, PA-C, ATC

Medical Physician Assistant · Atlanta, GA

NPI number 1114304284 Active

Practice location

1762 Clifton Rd NE, Ste 1650
Atlanta, GA 30322-4001

Call (978) 618-7329 Map

Mailing address

169 Redtail Rd
Jefferson, GA 30549-7070

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XAT001944 (GA)
Physician Assistant 363A00000XNone listed
Medical Physician Assistant Primary 363AM0700X9174 (GA)

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About NPI 1114304284

Roseann Pruitt, PA-C, ATC's National Provider Identifier is 1114304284, issued on Apr 28, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Atlanta, GA. The record was last updated on Mar 10, 2019.