Provider Demographics
NPI:1740727270
Name:SHEPPARD, NANCY R (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:R
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 ELBERT ST
Mailing Address - Street 2:
Mailing Address - City:ELBERTON
Mailing Address - State:GA
Mailing Address - Zip Code:30635-2633
Mailing Address - Country:US
Mailing Address - Phone:706-283-7095
Mailing Address - Fax:706-283-7166
Practice Address - Street 1:903 ELBERT ST
Practice Address - Street 2:
Practice Address - City:ELBERTON
Practice Address - State:GA
Practice Address - Zip Code:30635-2633
Practice Address - Country:US
Practice Address - Phone:706-283-7095
Practice Address - Fax:706-283-7166
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist