| Doctor Name: | SUSANNA M SHEPARD |
| NPI Number: | 1003992058 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 5005161 |
| Business Practice Address: | 609 N Highland St Gastonia, NC - 280522179 |
| Business Phone Number: | 7048535294 |
| Business Fax Number: | |
| Mailing Address: | 991 W Hudson Blvd, GASTONIA |
| State: | NC |
| Postal Code: | 280526430 |
| Phone Number: | 7048535294 |
| Fax Number: | |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 10/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5005161 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |