Provider Demographics
NPI:1144997669
Name:SHEPHERD, FRANCES D (LPN)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:D
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:
Other - Last Name:SHEPHERD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5284 VICTORIA LN APT 204
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-4358
Mailing Address - Country:US
Mailing Address - Phone:330-271-9547
Mailing Address - Fax:
Practice Address - Street 1:5284 VICTORIA LN APT 204
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-4358
Practice Address - Country:US
Practice Address - Phone:330-271-9547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.173990.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLPN.173990.MEDS-IVMedicaid