Healthcare Provider Details

I. General information

NPI: 1356239271
Provider Name (Legal Business Name): SHEILA MAE PRATT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 UPPER RIVERDALE RD APT 13L
JONESBORO GA
30236-1022
US

IV. Provider business mailing address

221 UPPER RIVERDALE RD APT 13L
JONESBORO GA
30236-1022
US

V. Phone/Fax

Practice location:
  • Phone: 678-709-7954
  • Fax: 678-709-7954
Mailing address:
  • Phone: 678-709-7954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberRN238924
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: