Healthcare Provider Details

I. General information

NPI: 1750066700
Provider Name (Legal Business Name): JESSICA MARIE SHIPPEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA MARIE SHIPPEE MCDANIEL

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2721 SE 10TH ST
TOPEKA KS
66607-1706
US

IV. Provider business mailing address

3111 LONGHORN DR
LAWRENCE KS
66049-1959
US

V. Phone/Fax

Practice location:
  • Phone: 785-783-8453
  • Fax:
Mailing address:
  • Phone: 913-449-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number594389
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-84481-122
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: