Shepard, Susanna M

Shepard, Susanna M is an individual health care provider with primary practice located at 609 N Highland St , Gastonia NC 28052-2179. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Shepard, Susanna M can be contacted via phone (704) 853-5294.

Contact Information

Primary practice address
609 N Highland St Gastonia NC 28052-2179
Phone: (704) 853-5294
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5005161 North Carolina

Profile Details

NPI number 1003992058
LBN Legal business name Shepard, Susanna M
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2006
Last updated Nov 4th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003992058 NPPES
South Carolina Other 3339776 GRANITE STATE MALPRACTICE
South Carolina Other 33N45 GRANITE STATE MALPRACTICE
South Carolina MEDICAID 7004977 GRANITE STATE MALPRACTICE

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