Provider Demographics
NPI:1376675249
Name:SHIPP, NANCY ANITA PERRY (PT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANITA PERRY
Last Name:SHIPP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:ANITA
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5351 HESPERUS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-1838
Mailing Address - Country:US
Mailing Address - Phone:410-245-5235
Mailing Address - Fax:
Practice Address - Street 1:PMRS, AVE D, BUILDING 23H, GROUND FLOOR
Practice Address - Street 2:VETERANS ADMINISTRATION MARYLAND HEALTH CARE SYSTEM
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:410-642-1052
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist