Provider Demographics
NPI:1073965141
Name:SHEPHARD, BRANDY (FNP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:SHEPHARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3238 PLAYERS CLUB CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125
Mailing Address - Country:US
Mailing Address - Phone:901-869-5744
Mailing Address - Fax:901-794-4128
Practice Address - Street 1:3238 PLAYERS CLUB CIR STE 58&59
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8843
Practice Address - Country:US
Practice Address - Phone:901-869-5744
Practice Address - Fax:901-794-4128
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF0716562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily