Individual
STEPHANIE ANNE SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8260 WILLOW OAKS CORPORATE DR STE 650, FAIRFAX, VA 22031-4531
(703) 776-2000
(571) 665-6797
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005117
VA
363A00000X
Physician Assistant
PA18335
CA
363AM0700X
Medical Physician Assistant
0010-01115
NC
Other
Enumeration date
03/24/2006
Last updated
12/21/2022
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