Individual
MARLENE S SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11234 ANDERSON ST, CRNA SERVICES DEPARTMENT, LOMA LINDA, CA 92354-2804
(909) 558-4000
Mailing address
11234 ANDERSON ST, CRNA SERVICES DEPARTMENT, LOMA LINDA, CA 92354-2804
(909) 558-4000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1467692052
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
54195
KS
Other
Enumeration date
03/01/2006
Last updated
09/23/2013
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