Provider Demographics
NPI:1588607162
Name:SHIPLEY, BRITT L (PA)
Entity Type:Individual
Prefix:MRS
First Name:BRITT
Middle Name:L
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2201 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1189
Mailing Address - Country:US
Mailing Address - Phone:610-375-4949
Mailing Address - Fax:
Practice Address - Street 1:2201 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1189
Practice Address - Country:US
Practice Address - Phone:610-375-4949
Practice Address - Fax:610-375-6233
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051240363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA081865Medicare PIN
PAQ02815Medicare UPIN