Provider Demographics
NPI:1154217370
Name:SHIPLEY, HEATHER COLETTE (MS, GC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:COLETTE
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:MS, GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-3224
Mailing Address - Country:US
Mailing Address - Phone:816-519-0309
Mailing Address - Fax:
Practice Address - Street 1:621 MEMORIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1063
Practice Address - Country:US
Practice Address - Phone:816-519-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS