Provider Demographics
NPI:1093050734
Name:SHIPP, VERNITA S (NP-C)
Entity Type:Individual
Prefix:MS
First Name:VERNITA
Middle Name:S
Last Name:SHIPP
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 VETERANS PKWY N
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31788-4171
Mailing Address - Country:US
Mailing Address - Phone:229-891-3513
Mailing Address - Fax:229-890-1986
Practice Address - Street 1:358 VETERANS PKWY N
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31788-4171
Practice Address - Country:US
Practice Address - Phone:229-891-3513
Practice Address - Fax:229-890-1986
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN127868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily