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General NPI Number Information
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NPI Number | 1194433441
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Entity Type | Individual
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Provider Name | KRISTA SHEPARD SEEDS PMHNP
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 228 PLAZA DR STE D
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-6054
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Country | US
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Telephone | 833-362-7935
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 METRO PKWY STE 205
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City | FORT MYERS
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State | FL
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Zip | 33916-9416
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Country | US
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Telephone | 833-362-7935
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11022788
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License Number State | FL
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