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NPI Code Detail

MEDICARE: STEPHANIE SHEPHERD

MEDICARE: STEPHANIE SHEPHERD
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
1363LF0000XFamily Nurse Practitioner71017622AIN
2163WC0200XCritical Care Medicine Registered Nurse28217309AIN

General Provider Information

NPI Number : 1255293841
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE SHEPHERD
Provider Business Mailing Address
First Line : 200 HIGH PARK AVE
Second Line :
City : GOSHEN
State : IN
Zip : 46526-4810
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 HIGH PARK AVE
Second Line :
City : GOSHEN
State : IN
Zip : 46526-4810
Country : US
Telephone Number : 574-364-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 01/09/2026

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Directions to “ STEPHANIE SHEPHERD ” Practice Location

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