Healthcare Provider Details

I. General information

NPI: 1780396549
Provider Name (Legal Business Name): SHEPHERD FAMILY CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 HIGHWAY 80 E
CALHOUN LA
71225-9113
US

IV. Provider business mailing address

1326 HIGHWAY 80 E
CALHOUN LA
71225-9113
US

V. Phone/Fax

Practice location:
  • Phone: 318-669-0137
  • Fax:
Mailing address:
  • Phone: 318-599-3050
  • Fax: 318-599-3051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: STEPHANIE JORDAN SHEPHERD
Title or Position: NP
Credential: APRN, FNP-C
Phone: 318-599-3050