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Individual

ELISE SHEPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
705 HALIBUT POINT RD, SITKA, AK 99835-7354
(907) 966-2150
(907) 966-2468
Mailing address
705 HALIBUT POINT RD, SITKA, AK 99835-7354
(907) 966-2150
(907) 966-2468

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH00055983
WA
183500000X
Pharmacist
Primary
PHAP1558
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH00055983
PHARMACY LICENSE
WA
01
PHAP1558
PHARMACY LICENSE
AK
Enumeration date
08/13/2020
Last updated
08/13/2020
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