MEDICARE: TESHA JO SHIPMAN-CURTIS CASE MANAGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1386135507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESHA JO SHIPMAN-CURTIS CASE MANAGER

Provider Business Mailing Address
First Line	:	122 CENTRAL PLZ N LOWR LEVEL
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44702-1448
Country	:	US
Telephone Number	:	234-804-3008
Fax Number	:	234-804-3024

Provider Business Practice Location Address
First Line	:	122 CENTRAL PLZ N LOWR LEVEL
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44702-1448
Country	:	US
Telephone Number	:	234-804-3008
Fax Number	:	234-804-3024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2018
Last Update Date	:	05/23/2018

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