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Contact Information

JEFFERY PRUDE
4253 N. CROSSOVER
FAYETTEVILLE, AR72703
 Phone: 479-464-5925
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for JEFFERY PRUDE · (Male)

NPI # 1295196533
Status Active
Credentials
Entity Individual
Enumeration date 03/15/2016
Last updated 03/15/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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