Healthcare Provider Details

I. General information

NPI: 1710745187
Provider Name (Legal Business Name): VALERIE A SIPAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 DELLWIN CT
COLUMBUS OH
43231-6164
US

IV. Provider business mailing address

3503 DELLWIN CT
COLUMBUS OH
43231-6164
US

V. Phone/Fax

Practice location:
  • Phone: 404-980-4009
  • Fax:
Mailing address:
  • Phone: 404-980-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number434396
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: