Provider Demographics
NPI:1336100627
Name:SHIPLEY, AMY A (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:A
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8264 GEORGE WASHINGTON MEMORIAL HIGHWAY
Mailing Address - Street 2:PO BOX 800
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061
Mailing Address - Country:US
Mailing Address - Phone:804-695-0305
Mailing Address - Fax:804-695-0804
Practice Address - Street 1:8264 GEORGE WASHINGTON MEMORIAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-4178
Practice Address - Country:US
Practice Address - Phone:804-695-0305
Practice Address - Fax:804-695-0804
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253382208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics