Provider Demographics
NPI:1770450538
Name:FARROW, SHELLY DIANE (DNP, MHA, RN)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:DIANE
Last Name:FARROW
Suffix:
Gender:F
Credentials:DNP, MHA, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 S BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8647
Mailing Address - Country:US
Mailing Address - Phone:281-782-0483
Mailing Address - Fax:
Practice Address - Street 1:2502 SW 14TH ST STE 8
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3301
Practice Address - Country:US
Practice Address - Phone:479-319-2346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR052226163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator