Doctor Name: | MS. DORA ELIZABETH SHANEYFELT |
NPI Number: | 1093797292 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, MSN, APN, CNS |
License Number: | A01359 ANP |
Business Practice Address: | 105 South Baltimore Manila, AR - 724420630 |
Business Phone Number: | 8705614421 |
Business Fax Number: | 8705613434 |
Mailing Address: | Po Box 630, 105 South Baltimore MANILA |
State: | AR |
Postal Code: | 724420630 |
Phone Number: | 8705614421 |
Fax Number: | 8705613434 |
NPI Enumeration Date: | 11/15/2005 |
NPI Last Update Date: | 05/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A01359 ANP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |