Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Khadijah Pruitt

Individual provider Registered Nurse · NPI 1508582396

Khadijah Pruitt is a Registered Nurse in Detroit, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2022

Practice location Address checks out

4646 John R St
Detroit, MI 48201-1916
Phone: (313) 576-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 4704315058 (MI)

Record details

NPI number1508582396
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 13, 2022
Last updated in NPPESOctober 13, 2022
Certification dateOctober 13, 2022

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