Basic Information
| Provider Information | |||||||||
| NPI: | 1366093957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRUITT | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | HOLLAND REUTHER | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2114 PINNACLE VIEW DR | ||||||||
| Address2: | |||||||||
| City: | KINGS MOUNTAIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280867610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7576728967 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 W GROVER ST | ||||||||
| Address2: | |||||||||
| City: | SHELBY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281503825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9804872800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2019 | ||||||||
| LastUpdateDate: | 09/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.