Provider Demographics
NPI:1639526627
Name:SHEPPARD, LINDSEY JOANNE (RN)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JOANNE
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 KARI CT
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-1324
Mailing Address - Country:US
Mailing Address - Phone:360-229-6013
Mailing Address - Fax:
Practice Address - Street 1:510 KARI CT
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-1324
Practice Address - Country:US
Practice Address - Phone:360-229-6013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00156225163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse