Provider Demographics
NPI:1518207828
Name:SHIPLEY, KATIE ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ELIZABETH
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 SW TOWER PARK DR
Mailing Address - Street 2:APT 431
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2504
Mailing Address - Country:US
Mailing Address - Phone:816-582-9982
Mailing Address - Fax:
Practice Address - Street 1:11879 W 112TH ST
Practice Address - Street 2:#100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2725
Practice Address - Country:US
Practice Address - Phone:913-338-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist