TINESHA SHANTA PETTIWAY NPI 1881375780

NPI Information

NPI: 1881375780
Provider Name: TINESHA SHANTA PETTIWAY
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
205 E MEDICAL CENTER BLVD # 100
WEBSTER, TX
ZIP 77598
Phone: (346) 800-6001
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Tinesha Shanta Pettiway is a gerontology nurse practitioner in Webster, TX with 1 years of experience. Tinesha Shanta Pettiway NPI is 1881375780. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

205 E MEDICAL CENTER BLVD # 100
WEBSTER, TX
ZIP 77598-376
Phone: (346) 800-6001

The NPI 1881375780 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/25/2023 and was last updated on 10/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	1129705	TEXAS	Yes
2	363LA2200X	Nurse Practitioner	Adult Health	1129705	TEXAS	No
3	363LF0000X	Nurse Practitioner	Family	1129705	TEXAS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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