MEDICARE: SHELIA PRUITT-ORR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	522420	TX
2	363LA2200X	Adult Health Nurse Practitioner	AP104901	TX
3	364SP1700X	Perinatal Clinical Nurse Specialist	AP104901	TX
4	363LW0102X	Women's Health Nurse Practitioner	AP104901	TX

General Provider Information

NPI Number	:	1386974426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELIA PRUITT-ORR

Provider Business Mailing Address
First Line	:	1304 S 25TH AVE
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78542-7205
Country	:	US
Telephone Number	:	956-686-5692
Fax Number	:	956-383-8864

Provider Business Practice Location Address
First Line	:	1304 S 25TH AVE
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78542-7205
Country	:	US
Telephone Number	:	956-686-5692
Fax Number	:	956-383-8864

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2010
Last Update Date	:	10/04/2016

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Directions to “ SHELIA PRUITT-ORR ” Practice Location

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