Jacqueline Shepard

Physician Assistant · Fort Wayne, IN

Individual Active NPI

NPI number 1003686908

Practice location

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 435-7001

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NPI record

NPI
1003686908
Entity type
Individual (Type 1)
Enumeration date
January 3, 2024
Last updated
March 30, 2026
Certified
March 30, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X — —
Physician Assistant 363A00000X 10004291A IN

Mailing address

5913 Hallowell Pl
Fort Wayne, IN 46815-6214
Phone
(815) 272-5409

Other practice locations (1)

  • 702 Van Buren St, Fort Wayne, IN 46802-3697 · (856) 686-4341

About Jacqueline Shepard

Jacqueline Shepard is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140. The NPI number 1003686908 was assigned on January 3, 2024 and the record was last updated on March 30, 2026.

Jacqueline Shepard lists a license in the registry: #10004291A (IN) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jacqueline Shepard?

The NPI number is 1003686908.

What is the phone number of Jacqueline Shepard?

The phone number listed for the practice location is (260) 435-7001.

Where is Jacqueline Shepard located?

7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140.

What is the taxonomy code for Jacqueline Shepard?

The primary taxonomy code is 363A00000X – Physician Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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