Sharva Pruitt, CLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

Practice address

27 Nantucket Dr
Lagrange, GA 30241-9504

Phone

(678) 590-9609

NPI assigned

Sep 29, 2021

Last updated

Sep 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1043982044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 NANTUCKET DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302419504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 NANTUCKET DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302419504",
            "telephone_number": "678-590-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "SHARVA",
        "credential": "CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Info@queenssprings.com",
            "affiliation": "N",
            "address_1": "27 Nantucket Dr",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302419504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lactation Consultant (Non-RN) in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Lactation Consultant (Non-RN) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.