Basic Information
Provider Information
NPI: 1487905295
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHIPLEY
FirstName: LAUREN
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 E LAHARPE ST
Address2:  
City: KIRKSVILLE
State: MO
PostalCode: 635014520
CountryCode: US
TelephoneNumber: 6606651962
FaxNumber: 6606653989
Practice Location
Address1: 8333 E BLUE PKWY
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641334750
CountryCode: US
TelephoneNumber: 8164747677
FaxNumber: 8167677671
Other Information
ProviderEnumerationDate: 09/20/2012
LastUpdateDate: 09/20/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X2012029028MOY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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