Shepherd, Scott

Shepherd, Scott is an individual health care provider with primary practice located at 3215 N Northhills Blvd , Fayetteville AR 72703-4424. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Shepherd, Scott can be contacted via phone (918) 664-9892.

Contact Information

Primary practice address
3215 N Northhills Blvd Fayetteville AR 72703-4424
Phone: (918) 664-9892
Fax: (918) 664-2521
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C01510 Arkansas

Profile Details

NPI number 1265475388
LBN Legal business name Shepherd, Scott
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Feb 10th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265475388 NPPES
Oklahoma MEDICAID 200051950A
Oklahoma MEDICAID 157034001
Oklahoma Other 771003601

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