Healthcare Provider Details

I. General information

NPI: 1588827521
Provider Name (Legal Business Name): LYNDA HELEN SHEPPARD RNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MADISON AVE SUITE 403
MORRISTOWN NJ
07960-7357
US

IV. Provider business mailing address

101 MADISON AVENUE SUITE 403
MORRISTOWN NJ
07960
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-7272
  • Fax: 973-267-9123
Mailing address:
  • Phone: 973-267-7272
  • Fax: 973-267-9123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number26NN07141600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: