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Individual

ALEXANDRA ANNE SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
109 GARDEN WALK, BREMEN, GA 30110-2451
(770) 840-5199
Mailing address
109 GARDEN WALK, BREMEN, GA 30110-2451
(770) 840-5199

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
XKL950W15960
BCBS
GA
Enumeration date
03/03/2023
Last updated
03/03/2023
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