Individual
MRS. SHANNON MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 685-6196
(479) 636-4587
Mailing address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R054648
AR
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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