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Individual

MARY T SHEPPARD

Active
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Individual

MARY T SHEPPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F380546
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02344723
NY
01
071112000039
FIDELIS
01
080407000110
FIDELIS
Enumeration date
04/24/2006
Last updated
05/16/2023
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If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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