Individual
TIFFANY LYNN SHANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3101 SE 14TH ST, BENTONVILLE, AR 72712
(479) 986-6090
(479) 986-6250
Mailing address
3101 SE 14TH ST, BENTONVILLE, AR 72712-4900
(479) 986-6090
(479) 986-6250
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005159
AR
Other
Enumeration date
05/19/2017
Last updated
07/21/2022
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