Individual
SHELLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7001 ROGERS AVE, SUITE 401, FORT SMITH, AR 72903-4073
(479) 314-4650
Mailing address
6107 IRONWOOD LN, FORT SMITH, AR 72916-8870
(479) 769-4835
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005000
AR
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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