Provider Demographics
NPI:1225545254
Name:SHEPARD, PATRICK ROBERT (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ROBERT
Last Name:SHEPARD
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 GIFFORD ST
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-5119
Mailing Address - Country:US
Mailing Address - Phone:508-457-4900
Mailing Address - Fax:
Practice Address - Street 1:360 GIFFORD ST
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-5119
Practice Address - Country:US
Practice Address - Phone:508-457-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2380491163W00000X
VT041.0133878225200000X
MA2380491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant