Individual
SHANNON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
942 HIGHWAY 65 N, MARSHALL, AR 72650-7772
(888) 518-1418
(501) 468-0468
Mailing address
4196 HIGHWAY 62 412 STE A, HARDY, AR 72542-8002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2025004733
MO
363LF0000X
Family Nurse Practitioner
Primary
233849
AR
Other
Enumeration date
03/31/2025
Last updated
06/26/2025
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