Provider Demographics
NPI:1205585528
Name:SIPP, ONESHA (FNP-C)
Entity type:Individual
Prefix:
First Name:ONESHA
Middle Name:
Last Name:SIPP
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37120 COBBLESTONE AVE
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3260
Mailing Address - Country:US
Mailing Address - Phone:225-400-3100
Mailing Address - Fax:
Practice Address - Street 1:37120 COBBLESTONE AVE
Practice Address - Street 2:
Practice Address - City:GEISMAR
Practice Address - State:LA
Practice Address - Zip Code:70734-3260
Practice Address - Country:US
Practice Address - Phone:225-400-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA838141363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner