Individual
JESSICA A SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5600 W LOVERS LN STE 100, DALLAS, TX 75209-4359
(214) 729-6299
(214) 935-5052
Mailing address
5600 W LOVERS LN STE 100, DALLAS, TX 75209-4359
(917) 561-5263
(214) 935-5052
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
42442
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000610798
ANTHEM
KY
01
—
000000610799
ANTHEM
KY
05
—
200945770
—
IN
01
—
3726869000
PASSPORT ADVANTAGE SPECIALITY
KY
01
—
3726873000
PASSPORT ADVANTAGE PCP
KY
01
—
3726877000
PASSPORT ADVANTAGE
KY
01
—
50024899
PASSPORT SPECIALITY
KY
01
—
50024903
PASSPORT PCP
KY
01
—
50024907
PASSPORT SPECIALITY
KY
05
—
7100074260
—
KY
01
—
9841363
AETNA
KY
Enumeration date
07/02/2008
Last updated
09/01/2023
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