Provider Demographics
NPI:1881899813
Name:SHEPHERD, MARSHA KAY (LPN)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:KAY
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5757
Mailing Address - Country:US
Mailing Address - Phone:419-624-6993
Mailing Address - Fax:419-624-6997
Practice Address - Street 1:216 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5757
Practice Address - Country:US
Practice Address - Phone:419-624-6993
Practice Address - Fax:419-624-6997
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385HR2065X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child