ALICE LYN SHEPARD (NPI# 1629333208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629333208 |
Entity Type | Individual |
Full Name | ALICE LYN SHEPARD |
Credential | PNP-BC |
Practice Address |
307 Boatner Rd Ste 114 Eglin Afb FL 32542 |
Mailing Address |
307 Boatner Rd Ste 114 Eglin Afb FL 32542-1302 |
Practice Telephone | 8508838550 |
Mailing Telephone | 8508838550 |
Enumeration Date | 2012-07-10 |
Last Update Date | 2018-08-03 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP130674 | TX | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851600258 | Alice R. Shepard | Psychologist | 31 W 9th St, Suite 1, New York, NY 10011-9206 | 2010-10-02 |
Street Address |
307 BOATNER RD STE 114 |
City | EGLIN AFB |
State | FL |
Zip Code | 32542 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134111453 | Thomas James Cantilina | Family Medicine | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2005-08-23 |
1861009466 | Patricia Allison Kellogg | Dietitian, Registered | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-09-28 |
1396367389 | Matthew Christopher Little | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-05-12 |
1750916961 | Joseph Roland Adamson | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-03-08 |
1447885181 | Deserea Marie Shoemaker | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1282 | 2020-03-03 |
1457985764 | Anaya Baeza | Nurse Practitioner | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-02-25 |
1043853435 | Sandra K Hoffa | Social Worker | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-10-18 |
1861042624 | Amy W Snow | Pharmacist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-09-13 |
1760042501 | Alison Natalie Snyder | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-06-14 |
1689237232 | Clint Copeland | Physical Therapist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-04-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417440306 | Colt Sicher | Student in an Organized Health Care Education/Training Program | 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 | 2018-06-14 |
1841679529 | Matthew Scurria | Dentist | 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 | 2015-05-27 |
1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
1548602923 | Gerald Jordan Novack | Psychologist | 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 | 2013-07-25 |
1699112821 | Taylor Anne Hahn | Obstetrics & Gynecology | 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 | 2013-05-29 |
1730456948 | Nicholas Brandon Sager | Dentist | 340 Boatner Rd, Eglin Afb, Apo, AA 32542 | 2011-11-17 |
1134402662 | Jessamy Jae Thornton | Student in an Organized Health Care Education/Training Program | 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 | 2011-09-21 |
1346523974 | Mary Elizabeth Sorrentino | Dentist | 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 | 2011-09-20 |
1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
Find all providers in zip 32542 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306830880 | Wanda Davis Hoffman | Nurse Practitioner | 307 Boatner Rd, Suite 114, Eglin Afb, FL 32542-1391 | 2005-09-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003417072 | Carmen Moreno | Nurse Practitioner | 336 Golfview Rd Apt 909, North Palm Beach, FL 33408-3512 | 2020-11-05 |
1366043614 | Christi Koshy | Nurse Practitioner | 4025 N Nob Hill Rd Apt 207, Sunrise, FL 33351-5811 | 2020-11-03 |
1730789322 | Michelle Yen-vera | Nurse Practitioner | 18409 Nw 9th Ct, Pembroke Pines, FL 33029-3607 | 2020-11-01 |
1376143487 | Aimee N Jorgenson Stough | Nurse Practitioner | 91550 Overseas Hwy Ste 209, Tavernier, FL 33070-2513 | 2020-10-28 |
1588271233 | Olivia Janelle De Jong | Nurse Practitioner | 424 Ne 6th St Apt D, Gainesville, FL 32601-5576 | 2020-09-28 |
1801407796 | Elisabeth Morley Chinlund | Nurse Practitioner | 445 Delmar Ter S Apt 5, Saint Petersburg, FL 33701-4653 | 2020-08-13 |
1972113025 | Nicole Horn | Nurse Practitioner | 8095 Spyglass Hill Rd Ste 104, Melbourne, FL 32940-8290 | 2020-08-04 |
1073131850 | Olivia Dawn Wilson | Nurse Practitioner | 5105 Clover Mist Dr, Apollo Beach, FL 33572-3417 | 2020-07-08 |
1427687565 | Cortney M Starr | Nurse Practitioner | 2261 Kingfisher Ln, Clearwater, FL 33762-3323 | 2020-04-01 |
1285263335 | Summer Leigh Moran | Nurse Practitioner | 528 W Baldwin Rd # A, Panama City, FL 32405-3313 | 2020-04-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.