Individual
TANNA SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1652 STATE HIGHWAY 22 W, DARDANELLE, AR 72834-2909
(479) 229-8000
(833) 637-1613
Mailing address
1652 STATE HIGHWAY 22 W, DARDANELLE, AR 72834-2909
(479) 229-8000
(833) 637-1613
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005012
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A005012
LICENSE NUMBER
AR
Enumeration date
01/23/2017
Last updated
02/13/2024
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