Individual
KELLIE MARIE SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CARE GIVER
Contact information
Practice address
686 SW LORRAINE DR, MADRAS, OR 97741-9333
(541) 325-1654
Mailing address
686 SW LORRAINE DR, MADRAS, OR 97741-9333
(541) 325-1654
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/27/2019
Last updated
12/27/2019
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