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General NPI Number Information
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NPI Number | 1639077639
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Entity Type | Individual
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Provider Name | EVELYN SHARRON KIPP CTRS
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Gender | Female
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Dates
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Enumeration Date | 10/29/2026
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Last Update Date | 10/29/2026
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Provider Practice Location Address
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Address Line | 2303 N AUGUSTA ST STE D APT D
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City | STAUNTON
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State | VA
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Zip | 24401-2597
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Country | US
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Telephone | 443-243-9113
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 AIKEN ST
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City | STAUNTON
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State | VA
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Zip | 24401-2038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number | 85721
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License Number State | VA
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