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General NPI Number Information
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NPI Number | 1336942598
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Entity Type | Individual
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Provider Name | KAYLEEN NICOLE SHEPPARD CMA/DA/CPR
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Gender | Female
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 1842 BOYD ST
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City | ASHLAND
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State | NE
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Zip | 68003-1751
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Country | US
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Telephone | 402-739-1428
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Fax |
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Provider Business Mailing Address
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Address Line | 1842 BOYD ST
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City | ASHLAND
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State | NE
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Zip | 68003-1751
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Country | US
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Telephone | 402-739-1428
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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