Provider Demographics
NPI:1245552868
Name:SHIPLEY, KENNETH STERLING (PHARMD)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:STERLING
Last Name:SHIPLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W MARIPOSA RD
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-1043
Mailing Address - Country:US
Mailing Address - Phone:520-761-4223
Mailing Address - Fax:520-761-1911
Practice Address - Street 1:300 W MARIPOSA RD
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-1043
Practice Address - Country:US
Practice Address - Phone:520-761-4223
Practice Address - Fax:520-761-1911
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist