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Individual

ANTHONY SHEPHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8442
Mailing address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8442

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
128605
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431692918
IL
05
918934316
MO
Enumeration date
01/11/2006
Last updated
11/05/2021
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