Kelley Jean Pruitt, CNS, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

602154 Issued in TX

Practice address

405 SE Access Rd
Iowa Park, TX 76367-6985

Phone

(940) 592-3500

Fax

(940) 592-4342

NPI assigned

Apr 29, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Electra Hospital District

  • Family Nurse Practitioner
  • Electra, TX
  • NPI 1417051806
  Medicare reassignment NPD
• Electra Hospital District

  • Critical Access Hospital
  • Electra, TX
  • NPI 1871583153
  Medicare reassignment NPD
• Electra Hospital District

  • Home Health Agency
  • Electra, TX
  • NPI 1417947706
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1871737254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1112",
            "city": "ELECTRA",
            "state": "TX",
            "postal_code": "763601112",
            "telephone_number": "940-495-3981",
            "fax_number": "940-432-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SE ACCESS RD",
            "city": "IOWA PARK",
            "state": "TX",
            "postal_code": "763676985",
            "telephone_number": "940-592-3500",
            "fax_number": "940-592-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "KELLEY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "CNS, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "602154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pablo Cortez Teveni, MD PA
• Laura Maye Palmer, CPHT
• Park Clinic PA
• Jacie Makaye Payton
• David Edmund Potter, D.O.
• Lauren Michelle Rains, D.C.
• Robin Denise Roberts, RN
• Barbara Joan Sampley
• Kristy Dean Shook, CPHT
• James Allen Speed, MD

• Family Nurse Practitioner in Iowa Park, TX
• Providers in Iowa Park, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.