Healthcare Provider Details

I. General information

NPI: 1306578893
Provider Name (Legal Business Name): MORGAN G SHIPPY RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 SE BAYBERRY LN STE 101
LEES SUMMIT MO
64063-4262
US

IV. Provider business mailing address

8120 STRAWBERRY HILL RD
ODESSA MO
64076-5384
US

V. Phone/Fax

Practice location:
  • Phone: 816-281-7558
  • Fax:
Mailing address:
  • Phone: 816-787-4745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberR105174
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: