Provider Demographics
NPI:1316199383
Name:PRATT, SHELESE MARIE (ND)
Entity type:Individual
Prefix:DR
First Name:SHELESE
Middle Name:MARIE
Last Name:PRATT
Suffix:
Gender:F
Credentials:ND
Other - Prefix:MS
Other - First Name:SHELESE
Other - Middle Name:MARIE
Other - Last Name:PRATT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:818 W SOUTH BOULDER RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2416
Mailing Address - Country:US
Mailing Address - Phone:303-819-6129
Mailing Address - Fax:720-287-1889
Practice Address - Street 1:818 W SOUTH BOULDER RD
Practice Address - Street 2:SUITE #200
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2416
Practice Address - Country:US
Practice Address - Phone:303-819-6129
Practice Address - Fax:720-287-1889
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1460175L00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath