Provider Demographics
NPI:1942099536
Name:SHEPARD, JANET (RN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11105 COUNTY ROAD 8000
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2078
Mailing Address - Country:US
Mailing Address - Phone:417-849-0247
Mailing Address - Fax:
Practice Address - Street 1:207 MATLOCK DR
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MO
Practice Address - Zip Code:65559-1034
Practice Address - Country:US
Practice Address - Phone:573-265-0448
Practice Address - Fax:573-814-6608
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018022655163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse