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General NPI Number Information
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NPI Number | 1710300660
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Entity Type | Individual
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Provider Name | REBECCA SHEPHERD APRN
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Gender | Female
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 403 SYCAMORE ST
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City | WILLIAMSBURG
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State | KY
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Zip | 40769-1153
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Country | US
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Telephone | 606-549-8244
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Fax | 606-549-0354
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Provider Business Mailing Address
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Address Line | PO BOX 1325
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City | CORBIN
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State | KY
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Zip | 40702-1325
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Country | US
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Telephone | 606-526-8131
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Fax | 606-528-8661
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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 | 3008495
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License Number State | KY
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