| Doctor Name: | SHAWNA RENEE MIDDLETON |
| NPI Number: | 1104104090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 2014001226 |
| Business Practice Address: | 805 Third St Horseshoe Bend, AR - 725123736 |
| Business Phone Number: | 8706704861 |
| Business Fax Number: | 8706704751 |
| Mailing Address: | Po Box 497, AUGUSTA |
| State: | AR |
| Postal Code: | 720060497 |
| Phone Number: | 8703472534 |
| Fax Number: | 8703473492 |
| NPI Enumeration Date: | 07/27/2011 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2014001226 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |