Provider Demographics
NPI:1528265451
Name:TRIPPIER, SHANNON (OTR)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:TRIPPIER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:TRIPPIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5507 SW 9TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106
Mailing Address - Country:US
Mailing Address - Phone:806-468-7611
Mailing Address - Fax:806-468-7603
Practice Address - Street 1:600 N 93RD ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2616
Practice Address - Country:US
Practice Address - Phone:402-391-2001
Practice Address - Fax:402-391-2004
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056007411225X00000X
TX115136225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist