Provider Demographics
NPI:1912631995
Name:SHIPMAN, MELODY ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:ANN
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S NATALIE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-9701
Mailing Address - Country:US
Mailing Address - Phone:141-776-1106
Mailing Address - Fax:
Practice Address - Street 1:2951 S CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-3632
Practice Address - Country:US
Practice Address - Phone:417-890-7924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022027382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist