Individual
MARILOU SHREVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APN
Contact information
Practice address
900 S 52ND ST, 200, ROGERS, AR 72758-8637
(479) 254-1100
Mailing address
507 NW C ST, BENTONVILLE, AR 72712-4747
(479) 422-5250
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
A01589
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146089758
—
AR
Enumeration date
09/06/2005
Last updated
05/13/2016
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