Individual provider · Type 1 NPI
Alice Lyn Shepard, PNP-BC
Pediatric Nurse Practitioner · Eglin Afb, FL
NPI number
1629333208
Active
Practice location
307 Boatner Rd Ste 114
Eglin Afb, FL 32542
Mailing address
2501 Capehart Rd
Bellevue, NE 68123
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | AP130674 (TX) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1629333208
Alice Lyn Shepard, PNP-BC's National Provider Identifier is 1629333208, issued on Jul 10, 2012. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Eglin Afb, FL. The record was last updated on Jun 28, 2023.