Individual
SHASTA DOCKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
15020 WADE BLVD., NORTH LITTLE ROCK, AR 72113
(501) 231-9732
Mailing address
15020 WADE BLVD, NORTH LITTLE ROCK, AR 72113-6876
(501) 231-9732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R104622
AR
Other
Enumeration date
07/03/2017
Last updated
07/21/2022
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