Individual
JESSICA A SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 DIECKS DR, ELIZABETHTOWN, KY 42701-2443
(270) 982-1244
Mailing address
100 DIECKS DR, ELIZABETHTOWN, KY 42701-2443
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1220321
KY
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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