Dawn Michelle Shepard, APRN

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Archer, FL

NPI 1992259477 · NPPES record last updated Jan 27, 2023

Key facts

NPI
1992259477
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
APRN3312562 (FL)
Practice address
16939 SW 134TH Ave
Archer, FL 32618-5413
Phone
(352) 265-2550
Fax
(352) 627-4785
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN3312562FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Past Accepting new patients
Compass Health, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN3312562 FL
Gerontology Nurse Practitioner 363LG0600X APRN3312562 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN3312562 FL Yes

Addresses

Primary practice location

16939 SW 134TH Ave
Archer, FL 32618-5413

Mailing address

PO Box 100187
Gainesville, FL 32610-0187
Phone (352) 265-2550

Other practice location 1

410 S 11th St
Lake Wales, FL 33853-4203
Phone (863) 419-2188

Other practice location 2

300 N 7th St
Bismarck, ND 58501-4439
Phone (701) 323-6000

Other providers in Archer, FL

All providers in Archer, FL · Psychiatric/Mental Health Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.