Provider Demographics
NPI:1457733875
Name:SHEARER, SHANNON LEE (APRN)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:LEE
Last Name:SHEARER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8544 EDGEMONT RD
Mailing Address - Street 2:
Mailing Address - City:GREERS FERRY
Mailing Address - State:AR
Mailing Address - Zip Code:72067-9401
Mailing Address - Country:US
Mailing Address - Phone:501-825-8800
Mailing Address - Fax:501-825-6319
Practice Address - Street 1:8544 EDGEMONT RD
Practice Address - Street 2:
Practice Address - City:GREERS FERRY
Practice Address - State:AR
Practice Address - Zip Code:72067-9401
Practice Address - Country:US
Practice Address - Phone:501-825-8800
Practice Address - Fax:501-825-6319
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily