Amanda L Shirron, APRN
Individual provider Active NPI Family Nurse Practitioner · Fayetteville, AR
NPI 1811312960 · NPPES record last updated Oct 1, 2024
Key facts
- NPI
- 1811312960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A004046 (AR)
- Practice address
- 1125 N College Ave
Fayetteville, AR 72703-1908 - Phone
- (479) 713-8701
- Fax
- (479) 713-8719
- NPI assigned
- Feb 26, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140903000384 | AR | Practitioner - Nurse Practitioner | 0143448217 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arcare | Current | Accepting new patients | |
| Arcare | Current |
Accepting new patients | |
| University of Arkansas for Medical Sciences | Current |
Accepting new patients | |
| Arcare | Current |
Accepting new patients |
Locations
623 N 9th St
#40
Augusta, AR 72006
1125 N College Ave
Fayetteville, AR 72703
Phone (479) 521-8260
14558 Highway 412
Huntsville, AR 72740
Phone (479) 351-0973
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A004046 | AR | Yes |
Addresses
Primary practice location
1125 N College Ave
Fayetteville, AR 72703-1908
Mailing address
1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 713-8701
Other practice location 1
14558 Highway 412
Huntsville, AR 72740-4036
Phone (479) 351-0973
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A004046 | Other | AR | AR LICENSE |
Other names
- Amanda L Milholen
Other providers in Fayetteville, AR
- Mary Teresa Shinn
- Randy J Shinn
- Diana L Shipman
- Leigh Elizabeth Shirey
- Ellen Shirley
- Gary Michael Short
- Whitney Shott
- Haley Madison Shover
- Shrauchle
- Dilasha Shrestha
All providers in Fayetteville, AR · Family 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 Oct 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.