Provider Demographics
NPI:1942456405
Name:SHEPARD, CAYLIN ELIZABETH (MSN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:CAYLIN
Middle Name:ELIZABETH
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6227 SADDLERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4633
Mailing Address - Country:US
Mailing Address - Phone:614-207-9079
Mailing Address - Fax:
Practice Address - Street 1:6227 SADDLERIDGE RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4633
Practice Address - Country:US
Practice Address - Phone:614-207-9079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily