Provider Demographics
NPI:1619760865
Name:SHEPHERD, JESSICA DENISE (DOULA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:DENISE
Last Name:SHEPHERD
Suffix:
Gender:X
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2372 EDEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-2121
Mailing Address - Country:US
Mailing Address - Phone:321-349-5055
Mailing Address - Fax:
Practice Address - Street 1:2372 EDEN PARK DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2121
Practice Address - Country:US
Practice Address - Phone:321-349-5055
Practice Address - Fax:321-349-5055
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula