Provider Demographics
NPI:1336942598
Name:SHEPPARD, KAYLEEN NICOLE (CMA/DA/CPR)
Entity type:Individual
Prefix:
First Name:KAYLEEN
Middle Name:NICOLE
Last Name:SHEPPARD
Suffix:
Gender:
Credentials:CMA/DA/CPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 BOYD ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1751
Mailing Address - Country:US
Mailing Address - Phone:402-739-1428
Mailing Address - Fax:
Practice Address - Street 1:1842 BOYD ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:NE
Practice Address - Zip Code:68003-1751
Practice Address - Country:US
Practice Address - Phone:402-739-1428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No126800000XDental ProvidersDental Assistant
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist