Abigail Jaiden Lerea Pruitt
Technician, Personal Care Attendant in Bradshaw, WV. Individual provider (NPI-1).
NPI number1942017157
StatusActive
Last updated in NPPESDec 12, 2024
Details
- NPI
- 1942017157
- Entity type
- Individual (NPI-1)
- Name
- Abigail Jaiden Lerea Pruitt
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 12, 2024
- Certification date
- Dec 9, 2024
- Last updated
- Dec 12, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
53 Nectar Dr Oozley Hollow RdBradshaw, WV 24817
Phone 336-413-9831
Mailing address
53 Nectar Dr Oozley Hollow RdBradshaw, WV 24817
Phone 336-413-9831
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