# MRS. STACY E SHEPPARD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1669725792
- **Gender:** F
- **Credential:** PMHNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 2012016535 | TN | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 64577 | WV | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APRN64577 | WV | Yes |

## Other

- **Enumeration date:** 10/26/2012
- **Last updated:** 07/16/2024