Provider Demographics
NPI:1053501650
Name:SHEPARD, TERRIE ELAINE (RPH)
Entity Type:Individual
Prefix:MS
First Name:TERRIE
Middle Name:ELAINE
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5459
Mailing Address - Country:US
Mailing Address - Phone:561-842-3796
Mailing Address - Fax:
Practice Address - Street 1:230 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5459
Practice Address - Country:US
Practice Address - Phone:561-842-3796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist