Provider Demographics
NPI:1902573298
Name:CARUTHERS, SHONTA JANAI
Entity Type:Individual
Prefix:
First Name:SHONTA
Middle Name:JANAI
Last Name:CARUTHERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5287 ETON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-4222
Mailing Address - Country:US
Mailing Address - Phone:252-331-9315
Mailing Address - Fax:
Practice Address - Street 1:5287 ETON DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-4222
Practice Address - Country:US
Practice Address - Phone:252-331-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management