Provider Demographics
NPI:1568292969
Name:SHEPPARD, ARTISHA KEA-SHELL
Entity type:Individual
Prefix:
First Name:ARTISHA
Middle Name:KEA-SHELL
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 CEDAR RD # 102
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7227
Mailing Address - Country:US
Mailing Address - Phone:757-687-9037
Mailing Address - Fax:
Practice Address - Street 1:752 CEDAR RD # 102
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-7227
Practice Address - Country:US
Practice Address - Phone:757-687-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services