Provider Demographics
NPI:1326511197
Name:SHEPHERD, AQEILA (DC)
Entity Type:Individual
Prefix:DR
First Name:AQEILA
Middle Name:
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20038 BRADFORD GREEN SQ
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-2599
Mailing Address - Country:US
Mailing Address - Phone:919-757-1160
Mailing Address - Fax:
Practice Address - Street 1:6224 FAYETTEVILLE RD STE 106B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6288
Practice Address - Country:US
Practice Address - Phone:919-544-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor