Derryin Ninaye Stampley, CPS

Individual provider Active NPI Prosthetist · Fayette, MS

NPI 1104580109 · NPPES record last updated Oct 26, 2021

Key facts

NPI
1104580109
Entity type
Individual (NPI type 1)
Primary specialty
Prosthetist 224P00000X
Practice address
28 Snyder Rd
Fayette, MS 39069-5051
Phone
(601) 809-6004
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic Fitter 225000000X
Prosthetist 224P00000X Yes

Addresses

Primary practice location

28 Snyder Rd
Fayette, MS 39069-5051

Mailing address

28 Snyder Rd
Fayette, MS 39069-5051
Phone (601) 809-6004

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL NinayesHairLab Health Information Exchange (HIE)

Other providers in Fayette, MS

All providers in Fayette, MS · Prosthetist in Mississippi

Sources for this page

Verify at the official NPI Registry.