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Individual

MR. JANICE ANNE SHIPLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1217 BONITA, GRANTS, NM 87020
(505) 287-2958
(505) 287-2403
Mailing address
1217 BONITA, GRANTS, NM 87020
(505) 287-2958
(505) 287-2403

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86337
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37960
NM
Enumeration date
09/16/2006
Last updated
07/23/2007
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