| Emily Diane Pruitt, | |
|
2106 Loop Rd, Winnsboro, LA 71295-3344 | |
| (318) 435-9411 | |
| (318) 435-9260 |
| Full Name | Emily Diane Pruitt |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 8 Years |
| Location | 2106 Loop Rd, Winnsboro, Louisiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760978449 | NPI | - | NPPES |
| F07181660 | Other | CERTIFICATION | |
| 14296793 | Other | CAQH | |
| 2478486 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | AP10208 (Louisiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lsu Health Sciences Center Shreveport Faculty Group Practice | 4082902721 | 512 |
| Calcasieu Urgent Care Llc | 5496908071 | 127 |
| Entity Name | Franklin Parish Hospital Service District No1 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619143120 PECOS PAC ID: 7810893302 Enrollment ID: O20031208000235 |
| Entity Name | Calcasieu Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467715490 PECOS PAC ID: 5496908071 Enrollment ID: O20130109000768 |
| Entity Name | Lsu Health Sciences Center Shreveport Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
| Mailing Address | Practice Location Address |
|---|---|
| Emily Diane Pruitt, 2106 Loop Rd, Winnsboro, LA 71295-3344 Ph: (318) 435-9411 | Emily Diane Pruitt, 2106 Loop Rd, Winnsboro, LA 71295-3344 Ph: (318) 435-9411 |
John Tyler Ulmer, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 Fair Ave, Winnsboro, LA 71295 Phone: 318-435-8020 | |
Mrs. Jessica Ellen Credle, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2106 Loop Rd Ste B, Winnsboro, LA 71295 Phone: 318-239-4860 Fax: 805-295-4715 | |
Mrs. Kimberly R Fannin - Trisler, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2106 Loop Rd # C, Winnsboro, LA 71295 Phone: 318-435-4571 Fax: 318-435-3842 | |
Jessica Williams Perry, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2106 Loop Rd Ste A, Winnsboro, LA 71295 Phone: 318-435-6363 Fax: 318-435-3842 | |
Samantha J Wood, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2104 Loop Rd Ste C, Winnsboro, LA 71295 Phone: 318-435-4571 | |
Mrs. Shelia Katheleen Perry, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 804 Polk St, Winnsboro, LA 71295 Phone: 318-435-6116 | |
Mr. Edward Clay Nichols, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3326 Front St, Winnsboro, LA 71295 Phone: 318-435-7333 Fax: 318-435-9061 |