Individual
LISA SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
609 S CLEARVIEW AVE, MESA, AZ 85208-1922
(480) 201-6754
(480) 396-5130
Mailing address
609 S CLEARVIEW AVE, MESA, AZ 85208-1922
(480) 201-6754
(480) 396-5130
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN046743
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124186
HEALTHNET
—
01
—
2224040
AETNA
—
Enumeration date
10/27/2006
Last updated
01/20/2016
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