Provider Demographics
NPI:1073409157
Name:CHIPURIRO, SHAMISO
Entity type:Individual
Prefix:
First Name:SHAMISO
Middle Name:
Last Name:CHIPURIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 ZERMATT AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8347
Mailing Address - Country:US
Mailing Address - Phone:629-278-0750
Mailing Address - Fax:
Practice Address - Street 1:3109 ZERMATT AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-8347
Practice Address - Country:US
Practice Address - Phone:629-278-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services