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Individual

TAMMY SHEPHERD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
501 CHESTNUT ST, BOSCOBEL, WI 53805-1130
(608) 485-2345
Mailing address
501 CHESTNUT ST, BOSCOBEL, WI 53805-1130
(608) 485-2345

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304407-31
WI

Other

Enumeration date
03/03/2016
Last updated
03/03/2016
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