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General NPI Number Information
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NPI Number | 1659981660
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Entity Type | Individual
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Provider Name | MADELINE MAHAN SHIPLEY
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 5500 E HARRY ST
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City | WICHITA
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State | KS
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Zip | 67218-3826
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Country | US
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Telephone | 316-686-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 711 E CLOUD AVE APT 2206
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City | ANDOVER
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State | KS
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Zip | 67002-8946
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Country | US
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Telephone | 913-370-0027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 1-101946
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License Number State | KS
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