Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 01032851A | IN |
NPI | 1033191945 |
---|---|
Provider Name | Dr. Janine S Sheppard |
First Address | Indianapolis, IN 46250-2691 |
Second Address | Indianapolis, IN 46250-2691 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 13/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D67860 | (02) | IN |