# SHANNAN SOUZA APRN LLC

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

## Provider details

- **NPI number:** 1992421622
- **Authorized official:** SHANNAN SOUZA APRN-CNP (OWNER)
- **Authorized official phone:** (479) 495-0821

## Contact information

- **Practice address:** 5150A SR 247, POTTSVILLE, AR 72858-6002
- **Practice address phone:** (479) 567-5680
- **Practice address fax:** (479) 567-5679
- **Mailing address:** 5150A SR 247, POTTSVILLE, AR 72858-6002
- **Mailing address phone:** (479) 567-5680
- **Mailing address fax:** (479) 567-5679

## Taxonomy

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

## Other

- **Enumeration date:** 10/14/2022
- **Last updated:** 11/02/2022