Healthcare Provider Details

I. General information

NPI: 1336459890
Provider Name (Legal Business Name): BRIANNE MURRAY SHEPPARD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GARDEN OF EDEN RD
WILMINGTON DE
19803-1511
US

IV. Provider business mailing address

408 NICHOLS AVE
WILMINGTON DE
19803-5234
US

V. Phone/Fax

Practice location:
  • Phone: 302-477-1536
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: