1942954698 NPI number — MRS. BRITTANY JEANE SHEPHERD FNP

Table of content: MRS. BRITTANY JEANE SHEPHERD FNP (NPI 1942954698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942954698 NPI number — MRS. BRITTANY JEANE SHEPHERD FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEPHERD
Provider First Name:
BRITTANY
Provider Middle Name:
JEANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KALUPSKI
Provider Other First Name:
BRITTANY
Provider Other Middle Name:
JEANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942954698
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33747 N SCOTTSDALE ROAD
Provider Second Line Business Mailing Address:
STE 135
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85266-1566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-795-8700
Provider Business Mailing Address Fax Number:
602-795-8701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33747 N SCOTTSDALE ROAD
Provider Second Line Business Practice Location Address:
STE 135
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85266-1566
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-795-8700
Provider Business Practice Location Address Fax Number:
602-795-8701
Provider Enumeration Date:
02/10/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  275659 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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