Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACKSON PRUETT
Active Sole ProprietorJACKSON PRUETT is a Independent Duty Corpsman healthcare provider located in FPO, AA, California. NPI 1407634272 is currently active in the NPPES registry. Verify at CMS.
Independent Duty Corpsman · FPO, AA, CA
Registration Details
- NPI Number
- 1407634272
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 21, 2023 (2.9021224413633 yrs)
- Last Updated
- Sep 21, 2023
- Sole Proprietor
- Yes
Practice Information
- Address
-
BLDG 4101, EL CAMINO REALFPO, AA, CA, 92058Browse CA providers · Browse ZIP 92058
- Phone
- 7607251288
- Primary Specialty
-
Independent Duty Corpsman
1710I1002X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.