Provider Demographics
NPI:1760117162
Name:SHEPPARD, HANNAH MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:MARIE
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28595 ORCHARD LAKE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2979
Mailing Address - Country:US
Mailing Address - Phone:485-530-0010
Mailing Address - Fax:
Practice Address - Street 1:25100 KELLY RD STE B
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4910
Practice Address - Country:US
Practice Address - Phone:248-553-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704330200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily