Provider Demographics
NPI:1427479401
Name:PRUITT, RACHEL (RN, BSN, CNOR, RNFA)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:PRUITT
Suffix:
Gender:F
Credentials:RN, BSN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 VITA CT
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6637
Mailing Address - Country:US
Mailing Address - Phone:406-579-0143
Mailing Address - Fax:
Practice Address - Street 1:915 HIGLAND BOULEVARD
Practice Address - Street 2:BOZEMAN DEACONESS HEALTH SERVICES
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-414-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN24893163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant