Individual
SERENA E. SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1921 STONECIPHER BLVD, ADA, OK 74820-3439
(580) 310-5687
Mailing address
1921 STONECIPHER BLVD, ADA, OK 74820-3439
(580) 310-5687
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0067512
OK
Other
Enumeration date
01/10/2006
Last updated
07/14/2020
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