Individual
MRS. NEELY POWER SHEPHEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
100 PROFESSIONAL PARK DR, CONWAY, SC 29526-9260
(843) 234-0005
Mailing address
100 PROFESSIONAL PARK DR, CONWAY, SC 29526-9260
(843) 234-0005
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23054
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6231
—
SC
Enumeration date
08/12/2019
Last updated
02/07/2020
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