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General NPI Number Information
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NPI Number | 1821920182
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Entity Type | Organization
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Legal Business Name | SHEPHERD VITALITY PLLC
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 784 S CLEARWATER LOOP STE B
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City | POST FALLS
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State | ID
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Zip | 83854-9599
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Country | US
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Telephone | 208-971-5035
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Fax | 208-279-7585
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Provider Business Mailing Address
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Address Line | 784 S CLEARWATER LOOP STE B
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City | POST FALLS
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State | ID
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Zip | 83854-9599
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Country | US
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Telephone | 208-971-5035
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Fax | 208-279-7585
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Authorized Official
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Title or Position | PRACTICE OWNER / NP
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Name | NINA TITCHENAL
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Credential | AGNP-C
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Telephone | 208-971-5035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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