Shannon McKinney
Individual provider Active NPI Women's Health Nurse Practitioner · Little Rock, AR
NPI 1609323658 · NPPES record last updated Sep 7, 2016
Key facts
- NPI
- 1609323658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Women's Health Nurse Practitioner 363LW0102X
- License
- A004386 (AR)
- Practice address
- 4815 W Markham St
Little Rock, AR 72205-3866 - Phone
- (501) 661-2000
- NPI assigned
- Sep 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
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
| License | State | Type | Specialty |
|---|---|---|---|
| A004386 | AR | MD | Women's Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | A004386 | AR | Yes |
Addresses
Primary practice location
4815 W Markham St
Little Rock, AR 72205-3866
Mailing address
719 Elkhart Loop
Bryant, AR 72022-3952
Phone (501) 454-6323
Other providers in Little Rock, AR
- Marcia McKenzie
- Meagan Shasidy McKenzie
- Standley McKinney Jr Jr.
- Bethany V. McKinney
- Daniele McKinney
- Wesley McKinney
- Alyson McKinnon
- Skyler McKinnon
- Cherry McKinstry
- Heather Denise McKinzie
All providers in Little Rock, AR · Women's Health Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.