Individual
JACKIE SHIPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12101 CAROL LN STE 101, FREDERICKSBURG, VA 22407-6104
(540) 741-9300
Mailing address
608 NW 9TH ST STE 1100, OKLAHOMA CITY, OK 73102-1015
(405) 272-7494
(405) 272-6985
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101286384
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
01/02/2026
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