Whitney Boni Pruitt, AGNP
Nurse Practitioner in Shallotte, NC. Individual provider (NPI-1).
NPI number1104543545
StatusActive
Last updated in NPPESApr 15, 2026
Details
- NPI
- 1104543545
- Entity type
- Individual (NPI-1)
- Name
- Whitney Boni Pruitt
- Credential
- AGNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 26, 2022
- Certification date
- Apr 15, 2026
- Last updated
- Apr 15, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 5017081 | NC | Yes |
| 363LP2300X | Nurse Practitioner, Primary Care | 5017081 | NC |
Practice location
512 Village Rd Ste 207Shallotte, NC 28470-3409
Phone 910-662-7500 · Fax 910-662-7501
Mailing address
Po Box 936857Atlanta, GA 31193-6857
Other practice locations
270 U.S. 701, Tabor City, Nc, 28463
Tabor City, NC 28463-2846
Tabor City, NC 28463-2846
Phone 910-653-1901 · Fax 910-320-8435
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All 21 Nurse Practitioner providers in Shallotte · All 468 providers in Shallotte
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