MEDICARE: LOYCE SHIPMAN

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1144023250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOYCE SHIPMAN

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6517 E ANDREW JOHNSON HWY
Second Line	:
City	:	WHITESBURG
State	:	TN
Zip	:	37891-9306
Country	:	US
Telephone Number	:	423-714-6055
Fax Number	:

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

Provider Enumeration Date	:	04/01/2025
Last Update Date	:	04/01/2025

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Directions to “ LOYCE SHIPMAN ” Practice Location

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