Individual
MRS. SHELLEY PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4411 HIGHWAY 5 N, BRYANT, AR 72022-7005
(501) 847-0289
(501) 847-8748
Mailing address
4411 HIGHWAY 5 N, BRYANT, AR 72022-7005
(501) 847-0289
(501) 847-8748
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A01505
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162274758
—
AR
01
—
5Y394
BCBS
—
01
—
A01505
CHAMPUS
AR
Enumeration date
09/06/2005
Last updated
03/23/2017
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