Provider Demographics
NPI:1831588789
Name:SHEPHERD, BRITTANY L
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:L
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 N 150 E
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:IN
Mailing Address - Zip Code:46701-9733
Mailing Address - Country:US
Mailing Address - Phone:260-438-9948
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5905
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20824-5905
Practice Address - Country:US
Practice Address - Phone:260-438-9948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN01080435A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program