=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962214031
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINDSEY SHIPLEY ENTERPRISES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2025
-----------------------------------------------------
Last Update Date | 07/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10258 N 5950 W
-----------------------------------------------------
City | HIGHLAND
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84003-9641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-367-7005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10258 N 5950 W
-----------------------------------------------------
City | HIGHLAND
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84003-9641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-367-7005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER, OWNER
-----------------------------------------------------
Name | LINDSEY SHIPLEY
-----------------------------------------------------
Credential | RN, IBCLC
-----------------------------------------------------
Telephone | 801-367-7005
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WL0100X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Registered Nurse)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174N00000X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Non-RN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------