Provider Demographics
NPI:1982428140
Name:SHEPARD, ASHLEY G (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:G
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WILDROSE CV
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4167
Mailing Address - Country:US
Mailing Address - Phone:870-565-6500
Mailing Address - Fax:
Practice Address - Street 1:1150 E MATTHEWS AVE STE 101
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4356
Practice Address - Country:US
Practice Address - Phone:870-243-0424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty