Individual
JACEY JOAN SHIPLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 638-6616
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN10022391
MA
367500000X
Certified Registered Nurse Anesthetist
RN10022391
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110232567A
—
MA
05
—
3153454
—
NH
Enumeration date
03/12/2025
Last updated
05/08/2026
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