Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | LE-00028960 | OH |
NPI | 1003469578 |
---|---|
Provider Name | Janey Faye Shipman |
First Address | Gahanna, OH 43230-5351 |
Second Address | Gahanna, OH 43230-5351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2019 |
Last Update Date | 14/08/2021 |