Healthcare Provider Details

I. General information

NPI: 1154266740
Provider Name (Legal Business Name): MRS. DEBBIE SHEPHERD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS DEBBIE PULVER

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 W 450 N
SANTAQUIN UT
84655-7919
US

IV. Provider business mailing address

127 W 450 N
SANTAQUIN UT
84655-7919
US

V. Phone/Fax

Practice location:
  • Phone: 801-361-3348
  • Fax:
Mailing address:
  • Phone: 801-361-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: