MEDICARE: KELLY SHIPLEY AG-ACNP, FNP, CNRN

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	363LA2100X	Acute Care Nurse Practitioner	76809	OK
2	363LF0000X	Family Nurse Practitioner	76809	OK

General Provider Information

NPI Number	:	1952843120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY SHIPLEY AG-ACNP, FNP, CNRN

Provider Business Mailing Address
First Line	:	3500 E FRANK PHILLIPS BLVD
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2411
Country	:	US
Telephone Number	:	918-331-1089
Fax Number	:	918-333-1823

Provider Business Practice Location Address
First Line	:	226 SE DEBELL AVE STE B
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2300
Country	:	US
Telephone Number	:	918-331-1060
Fax Number	:	918-331-1065

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

Provider Enumeration Date	:	11/04/2016
Last Update Date	:	02/09/2026

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