Provider Demographics
NPI:1255128120
Name:SHEPHERD, ANTHONY (PMHNP)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:SHEPHERD
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ROSS ST # 154-0455
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15262-0001
Mailing Address - Country:US
Mailing Address - Phone:703-841-1290
Mailing Address - Fax:
Practice Address - Street 1:7671 QUARTERFIELD RD STE 301
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4525
Practice Address - Country:US
Practice Address - Phone:240-617-1399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR248663363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health