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NPI Code Detail

MEDICARE: DEYANNIA SHIPP

MEDICARE:   DEYANNIA  SHIPP
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1255156998
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEYANNIA SHIPP
Provider Business Mailing Address
First Line : 5048 MILANGE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-2309
Country : US
Telephone Number : 747-274-8966
Fax Number :
Provider Business Practice Location Address
First Line : 5048 MILANGE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-2309
Country : US
Telephone Number : 747-274-8966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2024
Last Update Date : 12/14/2024

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Directions to “ DEYANNIA SHIPP ” Practice Location

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