MEDICARE: JANICE C SHIPPY ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	44773	KS
2	363L00000X	Nurse Practitioner	49798	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245222538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE C SHIPPY ARNP

Provider Business Mailing Address
First Line	:	1003 EAST DR
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7946
Country	:	US
Telephone Number	:	620-870-1425
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 E 5TH ST STE A
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74003-3942
Country	:	US
Telephone Number	:	918-213-4973
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	08/19/2022

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