Provider Demographics
NPI:1467581165
Name:SHEPHERD, CARA M (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:M
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:206 W COUNTY LINE RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2318
Mailing Address - Country:US
Mailing Address - Phone:303-888-6426
Mailing Address - Fax:303-302-1659
Practice Address - Street 1:206 W COUNTY LINE RD
Practice Address - Street 2:SUITE 340
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2318
Practice Address - Country:US
Practice Address - Phone:303-888-6426
Practice Address - Fax:303-302-1659
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2140363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467581165OtherNPI
COMM1374836OtherDEA