Shelley Tustison

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD10815 Issued in AR

Practice address

2608 SE J Street Suite 8, Mail Slot 0230
Bentonville, AR 72716-0001

Phone

(479) 360-3432

NPI assigned

Mar 22, 2021

Last updated

Mar 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1609452556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SW HAMILTON AVE",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727135005",
            "telephone_number": "870-919-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 SE J STREET SUITE 8, MAIL SLOT 0230",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160001",
            "telephone_number": "479-360-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUSTISON",
        "first_name": "SHELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD10815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Turner
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• Victoria Turner
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• Richard Duane Tutt, M.D.
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• Bailey Uldrich
• Susan Kay Umbaugh, OTRL
• Unbridled Holdings LLC

• Pharmacist in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.