Provider Demographics
NPI:1497034128
Name:SHEPPARD, RONALD M I (APRN, FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:M
Last Name:SHEPPARD
Suffix:I
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
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Mailing Address - Street 1:2687 PALMER ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1710
Mailing Address - Country:US
Mailing Address - Phone:406-493-3700
Mailing Address - Fax:406-493-3730
Practice Address - Street 1:2687 PALMER ST
Practice Address - Street 2:SUITE C
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1710
Practice Address - Country:US
Practice Address - Phone:406-493-3700
Practice Address - Fax:406-493-3730
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT37342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner