Individual
DANA MARIE SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1911 COOKS HILL RD, CENTRALIA, WA 98531-9073
(360) 736-6778
(360) 736-6552
Mailing address
1911 COOKS HILL RD, CENTRALIA, WA 98531-9073
(360) 736-6778
(360) 736-6552
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN00145561
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP30006273
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194SM
REGENCE
WA
01
—
2914SM
REGENCE
WA
05
—
7057375
—
WA
05
—
7122617
—
WA
05
—
7131709
—
WA
05
—
7131717
—
WA
01
—
9116SM
REGENCE
WA
05
—
9636994
—
WA
Enumeration date
03/28/2007
Last updated
04/14/2010
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