Provider Demographics
NPI:1023495538
Name:SHEPPARD-REECE, LINDA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SHEPPARD-REECE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-4965
Mailing Address - Country:US
Mailing Address - Phone:781-312-1393
Mailing Address - Fax:781-829-6902
Practice Address - Street 1:20 WINTER ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-4965
Practice Address - Country:US
Practice Address - Phone:781-312-1393
Practice Address - Fax:781-829-6902
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA281986163WG0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice