Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN2311397 | MA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 7428 | CT |
NPI | 1013440973 |
---|---|
Provider Name | Jessica Lynn Shippee |
First Address | Hartford, CT 06102-8000 |
Second Address | Fall River, MA 02720-3703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2017 |
Last Update Date | 03/10/2018 |