Individual
SHANNON RAE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
550 CAROTHERS LN, RUSSELLVILLE, AR 72802-8231
(479) 747-7913
Mailing address
550 CAROTHERS LN, RUSSELLVILLE, AR 72802-8231
(479) 747-7913
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A005875
AR
363LF0000X
Family Nurse Practitioner
A005875
AR
Other
Enumeration date
08/24/2018
Last updated
12/21/2020
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