Provider Demographics
NPI:1487911491
Name:PRUETT, ASHLEE ANN KAREUS (DO)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:ANN KAREUS
Last Name:PRUETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1380 W WINDHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5145
Mailing Address - Country:US
Mailing Address - Phone:970-201-1858
Mailing Address - Fax:
Practice Address - Street 1:5110 N 44TH ST STE L200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-1675
Practice Address - Country:US
Practice Address - Phone:602-343-2900
Practice Address - Fax:602-343-2901
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007317207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology