Individual
SHANNON BRITTANY KIPERASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(509) 714-5212
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1225886
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/12/2024
Last updated
11/21/2024
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