Provider Demographics
NPI:1598947525
Name:SHIPLETT, SANDRA DEE (LPN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:DEE
Last Name:SHIPLETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W WATER ST
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-1156
Mailing Address - Country:US
Mailing Address - Phone:740-605-9901
Mailing Address - Fax:
Practice Address - Street 1:515 W WATER ST
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-1156
Practice Address - Country:US
Practice Address - Phone:740-605-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 094642164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse