IndividualActive
Angel Shepherd
NPI 1073402335 · Licensed Practical Nurse · Watertown, NY
Provider details
- NPI number
- 1073402335
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 353253 (NY)
Specialties & taxonomies
Nursing Service Providers
Practice location
650 State St
Watertown, NY 13601-2839
Phone: (315) 755-1251
Fax: (315) 291-6601
Approximate (ZIP-level) locationGet directions
Mailing address
324 County Route 51 Bldg 1
Malone, NY 12953-4502
Registry dates
- Enumerated
- 2025-07-01
- Last updated
- 2025-07-01
- Certified
- 2025-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.