Individual
LISA J SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3024 STADIUM BLVD, JONESBORO, AR 72401-7415
(501) 227-0700
(501) 227-0744
Mailing address
304 COUNTY ROAD 388, JONESBORO, AR 72401-0184
(870) 972-5478
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CTP-000011
AR
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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