Individual
CHARMAYNE JAMES SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
HWY 160 M.P. 394-3, KAYENTA, AZ 86033
(928) 697-4112
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
(928) 697-4112
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
CSAZ86033
AZ
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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