TIFFANY LYNN SHANAHAN (NPI# 1750818894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750818894 |
| Entity Type | Individual |
| Full Name | TIFFANY LYNN SHANAHAN |
| Credential | NP-C |
| Practice Address |
3101 Se 14th St Bentonville AR 72712 |
| Mailing Address |
3101 Se 14th St Bentonville AR 72712-4900 |
| Practice Telephone | (479) 986-6090 |
| Practice Fax Number | 4799866250 |
| Mailing Telephone | 4799866090 |
| Mailing Fax Number | 4799866250 |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2018-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A005159 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Mercy Way Ste 20, Bella Vista, AR 727143000 | 4798025555 | |
| 701 Sw Regional Airport Blvd, Bentonville, AR 727124589 | 4793195200 |
| Street Address |
3101 SE 14TH ST |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760447353 | Rickey L Mcgath | Family Medicine | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2006-04-18 |
| 1093273195 | Melinda S Tucker | Nurse Practitioner | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2019-03-07 |
| 1568958833 | Meredith R Krohn | Nurse Practitioner | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2018-07-10 |
| 1194210070 | Jaime Marie Holthaus | Nurse Practitioner | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2018-06-25 |
| 1154810612 | Paige Boles | Registered Nurse | 3101 Se 14th St, Bentonville, AR 72712 | 2018-05-09 |
| 1750800827 | Smile Shoppe Bentonville Jeffrey D Rhodes Dds Ms Pllc | Dentist | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2017-09-11 |
| 1962937102 | Megan Elizabeth Owen | Nurse Practitioner | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2017-04-25 |
| 1982147765 | Tori Layne Abernathy | Nurse Practitioner | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2016-11-28 |
| 1972954600 | Rachel Angulo | Nurse Practitioner | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2016-06-23 |
| 1013381730 | Diana Rene Dunbar | Nurse Practitioner | 3101 Se 14th St, Bentonville, AR 72712-4900 | 2015-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720542145 | Kevin Copley | Nurse Practitioner | 1301 S Walton Blvd, Bentonville, AR 72712-6284 | 2019-01-30 |
| 1437655065 | Alysson Blythe Gaines | Nurse Practitioner | 1102 Nw Lowes Ave Ste 2, Bentonville, AR 72712-4978 | 2018-04-03 |
| 1629576152 | Dina Marie Wells | Nurse Practitioner | 3400 Se Macy Rd Ste 18, Bentonville, AR 72712-7844 | 2018-01-30 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1740649920 | Patricia Ellen Sheppard | Nurse Practitioner | 3400 Se Macy, Bentonville, AR 72712 | 2016-02-17 |
| 1740291525 | Pamela J Chrisco | Nurse Practitioner | 3400 Se Macy Rd, 18, Bentonville, AR 72712-7841 | 2006-08-10 |
| 1003805771 | Deborah Mullens Shirey | Nurse Practitioner | 1706 Se Walton Blvd., Ozark Urgent Care, Bentonville, AR 72712 | 2005-10-17 |
| 1326041831 | William G. Davis II | Nurse Practitioner | 1706 Se Walton Blvd, Bentonville, AR 72712-3200 | 2005-05-30 |
| 1215545298 | Alison A. Knox | Nurse Practitioner | 2805 Mid Cities Dr, Bentonville, AR 72712-4270 | 2020-07-16 |
| 1912548058 | Hannah Rae Lamm | Nurse Practitioner | 2900 Medical Center Pkwy, Bentonville, AR 72712-3204 | 2019-09-30 |
| Find all providers in BENTONVILLE | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
Please comment or provide details below to improve the information on TIFFANY LYNN SHANAHAN.
| 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.