Individual
CHESNEY V SHORTNACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6836 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 927-4100
(479) 927-4101
Mailing address
6836 ISAAC'S ORCHARD RD, SPRINGDALE, AR 72762
(479) 927-4100
(479) 927-4101
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273168795
MEDICAID PIN
AR
05
—
273243706
—
AR
Enumeration date
10/15/2021
Last updated
10/15/2021
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