Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5004473 | NC |
NPI | 1023341799 |
---|---|
Provider Name | Laura Shepanski |
First Address | Mebane, NC 27302-7636 |
Second Address | Mebane, NC 27302-7636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2009 |
Last Update Date | 14/09/2009 |