Provider Demographics
NPI:1306232145
Name:PRATT, TAKESHA (RRT)
Entity Type:Individual
Prefix:MRS
First Name:TAKESHA
Middle Name:
Last Name:PRATT
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 KNOLLCREST DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-9470
Mailing Address - Country:US
Mailing Address - Phone:423-305-2779
Mailing Address - Fax:
Practice Address - Street 1:6819 KNOLLCREST DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-9470
Practice Address - Country:US
Practice Address - Phone:423-305-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant