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NPI Code Detail

MEDICARE: STEPHANIE J SHEPHERD MSN, APRN, FNP-C

MEDICARE: STEPHANIE J SHEPHERD MSN, APRN, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN128690LA
2363L00000XNurse Practitioner220370LA

General Provider Information

NPI Number : 1013584101
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE J SHEPHERD MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 337 BRITTON RD
Second Line :
City : CALHOUN
State : LA
Zip : 71225-8502
Country : US
Telephone Number : 318-669-0137
Fax Number :
Provider Business Practice Location Address
First Line : 1326 HIGHWAY 80 E
Second Line :
City : CALHOUN
State : LA
Zip : 71225-9113
Country : US
Telephone Number : 318-599-3050
Fax Number : 318-599-3051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2021
Last Update Date : 05/24/2023

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