Healthcare Provider Details

I. General information

NPI: 1053239665
Provider Name (Legal Business Name): DEVYN SHIPMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 WESTOWN PKWY STE 175
WEST DES MOINES IA
50266-7760
US

IV. Provider business mailing address

613 SE 17TH ST
GRIMES IA
50111-6603
US

V. Phone/Fax

Practice location:
  • Phone: 515-216-4311
  • Fax:
Mailing address:
  • Phone: 515-783-6082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137424
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: