MEDICARE: LAURA SHEPHERD 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
1	363LF0000X	Family Nurse Practitioner	AP137893	TX

General Provider Information

NPI Number	:	1215400601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA SHEPHERD FNP-C

Provider Business Mailing Address
First Line	:	25402 NORTHWEST FWY STE 101
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-8685
Country	:	US
Telephone Number	:	281-304-1100
Fax Number	:	281-256-9105

Provider Business Practice Location Address
First Line	:	25402 NORTHWEST FWY STE 101
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-8685
Country	:	US
Telephone Number	:	281-304-1100
Fax Number	:	281-256-0205

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

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	11/27/2023

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Directions to “ LAURA SHEPHERD FNP-C” Practice Location

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