Healthcare Provider Details

I. General information

NPI: 1982428140
Provider Name (Legal Business Name): ASHLEY G SHEPARD APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 CHATEAU BLVD
PARAGOULD AR
72450-6279
US

IV. Provider business mailing address

1905 CHATEAU BLVD
PARAGOULD AR
72450-6279
US

V. Phone/Fax

Practice location:
  • Phone: 870-236-2265
  • Fax: 870-215-0772
Mailing address:
  • Phone: 870-236-2265
  • Fax: 870-215-0772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number217526
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number217526
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: