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Individual

SHANNON ADKINS KALKWARF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Mailing address
PO BOX 251420, LITTLE ROCK, AR 72225-1420
(501) 686-8000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A03296
AR
363LF0000X
Family Nurse Practitioner
Primary
A003296
AR
363LF0000X
Family Nurse Practitioner
AP130912
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
179910758
AR
01
5R605
BCBS
AR
01
5V3197113
MEDICARE CUMG GROUP
AR
01
5V3197666
MEDICARE FOR MCPG GROUP
AR
Enumeration date
09/01/2009
Last updated
09/08/2021
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