Provider Demographics
NPI:1689703951
Name:SHEPPARD, LANCE BISHOP (EMT-B)
Entity Type:Individual
Prefix:MR
First Name:LANCE
Middle Name:BISHOP
Last Name:SHEPPARD
Suffix:
Gender:M
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 476 BOX 135
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09036
Mailing Address - Country:US
Mailing Address - Phone:01149931-304-9858
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC BAVARIA (WUERZBURG)
Practice Address - Street 2:UNIT 26610
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09244
Practice Address - Country:US
Practice Address - Phone:01149931-804-3616
Practice Address - Fax:01149931-804-3214
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHB1430197146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic