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Individual

MARY C SHEPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4913 PROFESSIONAL CT, RALEIGH, NC 27609-4913
(252) 244-2388
(252) 244-0088
Mailing address
4913 PROFESSIONAL CT, RALEIGH, NC 27609-4913
(252) 244-2388

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
HC3278
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3418073
NC
05
6601442
NC
Enumeration date
05/16/2011
Last updated
05/16/2011
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