Provider Demographics
NPI:1558889618
Name:SHIPPS, CASEY NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:NICOLE
Last Name:SHIPPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:NICOLE
Other - Last Name:STREFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21853 S VINE ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:KS
Mailing Address - Zip Code:66083-9415
Mailing Address - Country:US
Mailing Address - Phone:785-221-3410
Mailing Address - Fax:
Practice Address - Street 1:784 N RIDGEVIEW RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-2900
Practice Address - Country:US
Practice Address - Phone:913-815-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105830111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE