Provider Demographics
NPI:1114226347
Name:SHEPHARD, TIMEIA MICHELE
Entity Type:Individual
Prefix:
First Name:TIMEIA
Middle Name:MICHELE
Last Name:SHEPHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 KNECHT CT
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-2231
Mailing Address - Country:US
Mailing Address - Phone:330-634-6619
Mailing Address - Fax:
Practice Address - Street 1:869 KNECHT CT
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-2231
Practice Address - Country:US
Practice Address - Phone:330-634-6619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide