Provider Demographics
NPI:1194387811
Name:SHIMMIN, RYLEE DANIELE
Entity Type:Individual
Prefix:
First Name:RYLEE
Middle Name:DANIELE
Last Name:SHIMMIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 MOUNTAIN CREEK RD APT 1009
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-6721
Mailing Address - Country:US
Mailing Address - Phone:470-216-0437
Mailing Address - Fax:
Practice Address - Street 1:3535 MOUNTAIN CREEK RD APT 1009
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-6721
Practice Address - Country:US
Practice Address - Phone:470-216-0437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer