Healthcare Provider Details

I. General information

NPI: 1174432686
Provider Name (Legal Business Name): LYNN MARIE SHEPARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 GREEN ST
GARDNER MA
01440-1373
US

IV. Provider business mailing address

10B MUSKETT DR
TEMPLETON MA
01468-1569
US

V. Phone/Fax

Practice location:
  • Phone: 978-630-6475
  • Fax:
Mailing address:
  • Phone: 508-331-2619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN204544
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: