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General NPI Number Information
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NPI Number | 1821965492
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Entity Type | Organization
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Legal Business Name | SHEPHDA SIGNATURE MOBILE WOUND CARE PLLC
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 1606 MOUNT CONNESS LN
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City | ROSHARON
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State | TX
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Zip | 77583-2989
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Country | US
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Telephone | 570-886-6870
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Fax | 570-886-6870
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Provider Business Mailing Address
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Address Line | 1606 MOUNT CONNESS LN
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City | ROSHARON
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State | TX
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Zip | 77583-2989
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Country | US
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Telephone | 570-886-6870
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Fax | 570-886-6870
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Authorized Official
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Title or Position | FOUNDER
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Name | DANIEL MUGIRO NYANCHOKA
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Credential | DNP, FNP, WCS
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Telephone | 570-886-6870
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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 |
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License Number State |
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