Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. SHANNON ELIZABETH DERRICKS, ATC
ActiveAthletic Trainer · SPRINGFIELD, MO
Registration Details
- NPI Number
- 1114919057
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 17, 2005 (20.676981940885 yrs)
- Last Updated
- Jul 8, 2007
- License
-
109649 (MO)
Practice Information
- Address
-
901 S NATIONAL AVEATHLETIC TRAINING SERVICESSPRINGFIELD, MO, 658040027Browse MO providers · Browse ZIP 65804
- Phone
- 4178365461
- Fax
- 4178366101
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in SPRINGFIELD, MO
| Name | Credential | NPI |
|---|---|---|
| IVAN EUGENE MILTON | AT | 1841291747 |
| MR. JAMES THOMAS PENKALSKI | ATC | 1073505921 |
| MS. ROBIN E MEEKS | ATC | 1376535211 |
| MS. TIMAREE ANNE WALSH | ATC | 1114919628 |
| MRS. JENNIFER MARIE PROBSTFIELD | ATC | 1932192895 |
| MR. STEPHEN PAUL SAWCHAK | AT | 1316930134 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.