Provider Demographics
NPI:1245995992
Name:SHEPHERD, CAMEIKA ODELVEZ (APRN)
Entity type:Individual
Prefix:
First Name:CAMEIKA
Middle Name:ODELVEZ
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5011 GATE PARKWAY
Mailing Address - Street 2:BLDG 100 STE 100
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-571-7239
Mailing Address - Fax:866-380-0827
Practice Address - Street 1:5011 GATE PARKWAY
Practice Address - Street 2:BLDG 100 STE 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-3225
Practice Address - Country:US
Practice Address - Phone:904-512-7239
Practice Address - Fax:866-380-0827
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-07
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016040163W00000X, 207R00000X, 208VP0000X
FL11016040363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty