Provider Demographics
NPI:1013584101
Name:SHEPHERD, STEPHANIE J (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-8502
Mailing Address - Country:US
Mailing Address - Phone:318-669-0137
Mailing Address - Fax:
Practice Address - Street 1:1326 HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:LA
Practice Address - Zip Code:71225-9113
Practice Address - Country:US
Practice Address - Phone:318-599-3050
Practice Address - Fax:318-599-3051
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN128690163W00000X
LA220370363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse