Healthcare Provider Details

I. General information

NPI: 1467828285
Provider Name (Legal Business Name): LINDSEY SHIPLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2015
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10258 N 5950 W
HIGHLAND UT
84003-9641
US

IV. Provider business mailing address

10258 N 5950 W
HIGHLAND UT
84003-9641
US

V. Phone/Fax

Practice location:
  • Phone: 801-367-7005
  • Fax:
Mailing address:
  • Phone: 801-367-7005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-57270
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number7737075-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: