Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 3008346 | KY |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 3008346 | KY |
N | 363LW0102X | Nurse Practitioner - Women's Health | 3008346 | KY |
NPI | 1003230731 |
---|---|
Provider Name | Victoria Jean Shipman |
First Address | Chicago, IL 60677-6347 |
Second Address | Louisville, KY 40202-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2014 |
Last Update Date | 05/03/2021 |