Individual
RYAN SHEPHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-7070
(731) 541-7075
Mailing address
620 SKYLINE DR, JACKSON, TN 38301-3923
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
16939
TN
Other
Enumeration date
08/22/2012
Last updated
08/22/2012
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