Individual
REBECCA C SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
402 W MORROW RD, SAND SPRINGS, OK 74063-6549
(918) 245-1328
(918) 293-3181
Mailing address
402 W MORROW RD, SAND SPRINGS, OK 74063-6549
(918) 245-1328
(918) 293-3181
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1291
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200024950A
—
OK
05
—
200024950B
—
OK
Enumeration date
09/13/2005
Last updated
01/08/2014
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