MEDICARE: KRYSTAL J JONES-SHEPHARD MSN, APRN, AGNP-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	363LG0600X	Gerontology Nurse Practitioner	APRN.CNP.022560	OH

General Provider Information

NPI Number	:	1447747589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTAL J JONES-SHEPHARD MSN, APRN, AGNP-C

Provider Business Mailing Address
First Line	:	3433 JEANNETTE AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-1606
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 EASTGATE RD STE B
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-3024
Country	:	US
Telephone Number	:	567-228-2359
Fax Number	:

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

Provider Enumeration Date	:	04/14/2018
Last Update Date	:	08/14/2025

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