SHENISE LASTINE PRUITT NPI 1477879351

NPI Information

NPI: 1477879351
Provider Name: SHENISE LASTINE PRUITT
Classification: Contractor - 171W00000X
Entity Type: Individual
Address:
9648 OLIVE BLVD
OLIVETTE, MO
ZIP 63132
Phone: (314) 641-9930
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Shenise Lastine Pruitt is a contractor in Olivette, MO. The provider is a person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). Shenise Lastine Pruitt NPI is 1477879351. 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:

9648 OLIVE BLVD
OLIVETTE, MO
ZIP 63132-002
Phone: (314) 641-9930

The enumeration date for this NPI number is 4/16/2010 and was last updated on 4/16/2010.

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	171W00000X	Contractor			MISSOURI	Yes

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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