Provider Demographics
NPI:1780417535
Name:SHEPARD, ALEXANDRIA LEIGH (NP)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:LEIGH
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LONGSHANK CIR
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-7906
Mailing Address - Country:US
Mailing Address - Phone:508-274-5262
Mailing Address - Fax:
Practice Address - Street 1:360 GIFFORD ST
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-5119
Practice Address - Country:US
Practice Address - Phone:508-457-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2380667363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health