Provider Demographics
NPI:1427389360
Name:DRAZY-SHEDD, DENISE JOANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:JOANNE
Last Name:DRAZY-SHEDD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3236 HOLMAN WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1155
Mailing Address - Country:US
Mailing Address - Phone:775-358-1374
Mailing Address - Fax:
Practice Address - Street 1:3236 HOLMAN WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-1155
Practice Address - Country:US
Practice Address - Phone:775-358-1374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1477225100000X
MEPT163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist