Individual
SCOTT SHEPHERD
Active
Individual
SCOTT SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C01510
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157034001
—
AR
05
—
200051950A
—
OK
01
—
771003601
ARKANSAS BREASTCARE
AR
Enumeration date
06/14/2006
Last updated
02/10/2012
Update your record
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