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General NPI Number Information
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NPI Number | 1346930385
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Entity Type | Organization
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Legal Business Name | SHEPARD HEALTH, LLC.
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 540 SAINT ANDREWS RD STE 215B
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City | COLUMBIA
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State | SC
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Zip | 29210-4500
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Country | US
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Telephone | 803-290-6357
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Fax |
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Provider Business Mailing Address
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Address Line | 752 DEERWOOD CROSSING DR
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City | COLUMBIA
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State | SC
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Zip | 29229-8244
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Country | US
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Telephone | 803-290-6357
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | RACHELLE SHEPARD
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Credential | NP
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Telephone | 803-290-6357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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