Healthcare Provider Details

I. General information

NPI: 1649775156
Provider Name (Legal Business Name): KAREN JUNE SHIPPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 HIGH POINT BLVD
BETHLEHEM PA
18017-7806
US

IV. Provider business mailing address

28 S 1ST ST
BANGOR PA
18013-2612
US

V. Phone/Fax

Practice location:
  • Phone: 610-954-5433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN334654L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: