Provider Demographics
NPI:1811233406
Name:SHIPLEY, CRAIG (APRN-NP)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:SHIPLEY
Suffix:
Gender:M
Credentials:APRN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:DEPARTMENT OF NURSING
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-7220
Mailing Address - Country:US
Mailing Address - Phone:913-945-8769
Mailing Address - Fax:913-945-8770
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:DEPARTMENT OF NURSING
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-7220
Practice Address - Country:US
Practice Address - Phone:913-945-8769
Practice Address - Fax:913-945-8770
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily