MRS. SHONTA ELLISON


Address: 130 Lake Valley Dr, Maumelle, AR 72113-5939
Phone: 5017661884

MRS. SHONTA ELLISON (NPI# 1487138608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487138608
Entity Type Individual
Full Name MRS. SHONTA ELLISON
Credential APRN
Practice Address 130 Lake Valley Dr
Maumelle
AR 72113-5939
Practice Telephone 5017661884
Mailing Telephone 5017661884
Enumeration Date 2018-09-24
Last Update Date 2018-09-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 364SA2200X Clinical Nurse Specialist
Specialization: Adult Health
S002325 AR Physician Assistants & Advanced Practice Nursing Providers
N 364SG0600X Clinical Nurse Specialist
Specialization: Gerontology
S002325 AR Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AR CNS S002325 01

Office Location

Street Address 130 LAKE VALLEY DR
City MAUMELLE
State AR
Zip Code 72113-5939

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1104347814 Shasta Dockery Registered Nurse 15020 Wade Blvd., North Little Rock, AR 72113 2017-07-03
1235669839 Robert Mitchell Fisher Specialist/Technologist 134 Vienne Pl, Maumelle, AR 72113 2017-06-15
1932516887 Healthcare Express, LLP Clinic/Center 11819 Maumelle Blvd., North Little Rock, AR 72113 2014-07-11
1184997991 Preston Lewis Speech-Language Pathologist 14 Braeswood Place, Maumelle, AR 72113 2012-02-10
1740437813 Jennifer L Franklin Social Worker 115 Audubon Dr Ste 9a, Maumelle, AR 72113 2008-08-20
1861655912 Dawn Melton Mulkern Dietitian, Registered 12 Ninth Fairway Loop, Maumelle, AR 72113 2008-07-09
1902028723 Robin Reynolds Dietitian, Registered 9300 White Oak Crossing, N Little Rock, AR 72113 2007-05-02
1316096498 Caretech Medical, Inc. Durable Medical Equipment & Medical Supplies 8010 Counts Massie Rd, Suite B, North Little Rock, AR 72113 2007-01-09
1548318470 Supermarket Investors Inc Pharmacy 1117 Audubon Dr, Maumelle, AR 72113 2007-01-08
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Taxonomy Information

Taxonomy Code 364SA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871126698 Sarah Lowtharp Clinical Nurse Specialist 225 East Washington Ave., Jonesboro, AR 72401 2020-02-20
1275182677 Central Arkansas Screening and Medical Services Clinical Nurse Specialist 801 W. Locust St, Cabot, AR 72023 2019-09-09
1740731660 Holly Bunn Clinical Nurse Specialist 41 Harding Dr, Searcy, AR 72143-5704 2016-10-14
1457808362 Candice Caldwell Clinical Nurse Specialist 1809 Ozarka College Dr, Mountain View, AR 72560-6455 2016-09-08
1548672413 Angela Pugsley Clinical Nurse Specialist 900 Enterprise Dr, Jonesboro, AR 72401-9239 2014-05-27
1104164706 Betty D Corley Clinical Nurse Specialist 4 Redhead Dr, Conway, AR 72032-9756 2013-01-17
1255677027 Brandi Nicole Sharp Clinical Nurse Specialist 421 W Wade Ave, Mountain Home, AR 72653-4622 2012-12-21
1760744080 Elizabeth H Jarvis Clinical Nurse Specialist 500 S University Ave Ste 500, Little Rock, AR 72205-5307 2012-06-12
1134489842 Barbara Frances Gray Clinical Nurse Specialist 2020 Hytrol St, Jonesboro, AR 72401-6712 2012-05-29
1881913408 Nelson Andrew Seal Clinical Nurse Specialist 4 Charithcher Ln, Bella Vista, AR 72714-3247 2010-05-21
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Competitor

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City MAUMELLE
Zip Code 72113

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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