Individual
MISS JANET LEE SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
620 E MONROE ST, MEXICO, MO 65265-2919
(573) 582-5000
(573) 582-3729
Mailing address
2104 DICKINSON CT, COLUMBIA, MO 65202-3322
(573) 214-0088
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
146023
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146023
STATE LICENSE
MO
Enumeration date
07/07/2006
Last updated
07/08/2007
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