Individual
MELINDA PEARL SHEPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
5300 PATRON PLACE, SUMMERVILLE, SC 29485
(862) 230-4894
Mailing address
534 S 11TH ST APT 1, NEWARK, NJ 07103-2397
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
3747A0650X
Attendant Care Provider
—
—
376K00000X
Nurse's Aide
Primary
9992889
SC
Other
Enumeration date
02/21/2020
Last updated
08/01/2023
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