Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 281986 | MA |
NPI | 1023495538 |
---|---|
Provider Name | Linda Sheppard-Reece |
First Address | Pembroke, MA 02359-4965 |
Second Address | Pembroke, MA 02359-4965 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2015 |
Last Update Date | 26/04/2017 |