# SHANEYFELT CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124175773
- **Authorized official:** MS. DORA ELIZABETH SHANEYFELT MSN, APN, CNS (OWNER AND ADVANCED PRACTICE NURSE)
- **Authorized official phone:** (870) 561-4421

## Contact information

- **Practice address:** 105 S. BALTIMORE, MANILA, AR 72442-0630
- **Practice address phone:** (870) 561-4421
- **Practice address fax:** (870) 561-3434
- **Mailing address:** PO BOX 630, 105 SOUTH BALTIMORE STREET, MANILA, AR 72442-0630
- **Mailing address phone:** (870) 561-4421
- **Mailing address fax:** (870) 561-3434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2007
- **Last updated:** 05/24/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 162966002 | — | AR |