Individual provider · Type 1 NPI

Johnny Shipp

Student in an Organized Health Care Education/Training Program · Columbia, MO

NPI number 1558820167 Active

Practice location

600 East Stadium Boulevard
Columbia, MO 65211-0001

Call (573) 476-7780 Map

Mailing address

RR 3 Box 3624
Thayer, MO 65791-9309

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1558820167

Johnny Shipp's National Provider Identifier is 1558820167, issued on Mar 14, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Columbia, MO. The record was last updated on Mar 14, 2019.