Provider Demographics
NPI:1154092427
Name:SHEPARD, AIMEE ELIZABETH (FNP-C)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:ELIZABETH
Last Name:SHEPARD
Suffix:
Gender:F
Credentials: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:PO BOX 44325
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83711-0325
Mailing Address - Country:US
Mailing Address - Phone:208-695-0388
Mailing Address - Fax:208-606-3682
Practice Address - Street 1:3719 WHEELER CIR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-7949
Practice Address - Country:US
Practice Address - Phone:208-695-0388
Practice Address - Fax:208-606-3682
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-25
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID56999363LF0000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health