Provider Demographics
NPI:1558192039
Name:SHEPHERD, JESSICA RENEE (NNP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:RENEE
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RENEE
Other - Last Name:NOWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:813 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2431
Mailing Address - Country:US
Mailing Address - Phone:919-610-7720
Mailing Address - Fax:
Practice Address - Street 1:CONE HEALTH WOMEN'S AND CHILDREN'S CENTER
Practice Address - Street 2:1200 N ELM STREET, ENTRANCE C
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-832-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020548363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal