Individual
SHANNON KAIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5900 W STONEY BROOK RD APT 14207, ROGERS, AR 72758
(815) 830-2806
Mailing address
2106 LOUDENSLAGER DR, THOMPSONS STATION, TN 37179-5312
(815) 830-2806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/05/2016
Last updated
07/17/2018
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