Individual
KELAJAH SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2847 TEASLEY DR, PEARL, MS 39208-5849
(601) 278-6796
Mailing address
2847 TEASLEY DR, PEARL, MS 39208-5849
(601) 278-6796
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
Primary
—
MS
374J00000X
Doula
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
MS
01
—
568946544
BCBS
ME
01
—
5874
HEALTH PARTNERS
—
Enumeration date
03/06/2023
Last updated
03/06/2023
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