MEDICARE: RAKIA SHEPARD RN

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
1	163W00000X	Registered Nurse	RN519435	OH

General Provider Information

NPI Number	:	1023384807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAKIA SHEPARD RN

Provider Business Mailing Address
First Line	:	2675 WINNINGWILLOW DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-3471
Country	:	US
Telephone Number	:	614-377-9038
Fax Number	:

Provider Business Practice Location Address
First Line	:	5150 E MAIN ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2441
Country	:	US
Telephone Number	:	614-946-5504
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	08/14/2024

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