Provider Demographics
NPI:1730974148
Name:SHIPMAN, TAMEKA
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:
Last Name:SHIPMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 DOVE TREE LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6693
Mailing Address - Country:US
Mailing Address - Phone:919-895-2642
Mailing Address - Fax:
Practice Address - Street 1:5821 POYNER VILLAGE PKWY STE 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-3487
Practice Address - Country:US
Practice Address - Phone:919-895-2642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist