Individual
MS. ERSALENE SHORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 SHUFFIELD DR, LITTLE ROCK, AR 72205-7100
(501) 686-9300
Mailing address
116 LATONA LN APT 22, NORTH LITTLE ROCK, AR 72118-3201
(501) 563-8683
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169190795
—
AR
Enumeration date
11/30/2009
Last updated
11/30/2009
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