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General NPI Number Information
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NPI Number | 1952843120
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Entity Type | Individual
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Provider Name | KELLY SHIPLEY AG-ACNP, FNP, CNRN
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Gender | Female
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 226 SE DEBELL AVE STE B
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City | BARTLESVILLE
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State | OK
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Zip | 74006-2300
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Country | US
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Telephone | 918-331-1060
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Fax | 918-331-1065
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Provider Business Mailing Address
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Address Line | 3500 E FRANK PHILLIPS BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74006-2411
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Country | US
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Telephone | 918-331-1089
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Fax | 918-333-1823
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 76809
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 76809
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License Number State | OK
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