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Individual

ANTHONY TRAYVON SHEPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6060 SILVER LAKE RD APT 13G, RENO, NV 89506-1782
(775) 303-6446
Mailing address
6060 SILVER LAKE RD APT 13G, RENO, NV 89506-1782
(775) 303-6446

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
0806091399
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0806091399
NV
Enumeration date
02/06/2023
Last updated
02/06/2023
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