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General NPI Number Information
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NPI Number | 1154092427
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Entity Type | Individual
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Provider Name | AIMEE ELIZABETH SHEPARD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 3719 WHEELER CIR
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City | NAMPA
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State | ID
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Zip | 83686-7949
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Country | US
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Telephone | 208-695-0388
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Fax | 208-606-3682
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Provider Business Mailing Address
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Address Line | PO BOX 44325
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City | BOISE
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State | ID
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Zip | 83711-0325
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Country | US
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Telephone | 208-695-0388
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Fax | 208-606-3682
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 56999
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 56999
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License Number State | ID
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