Basic Information
| Provider Information | |||||||||
| NPI: | 1437881406 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHEPHERD | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 770 S HIGHWAY 99 | ||||||||
| Address2: | |||||||||
| City: | FILLMORE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846315033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4352538000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 770 SOUTH HIGHWAY 99 | ||||||||
| Address2: | |||||||||
| City: | FILLMORE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4352538000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2022 | ||||||||
| LastUpdateDate: | 10/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 323707-4405 | UT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.