Healthcare Provider Details

I. General information

NPI: 1144642398
Provider Name (Legal Business Name): SHAUNA HARP R.R.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WESTON LN
BELLA VISTA AR
72715-2301
US

IV. Provider business mailing address

10 WESTON LN
BELLA VISTA AR
72715-2301
US

V. Phone/Fax

Practice location:
  • Phone: 479-685-2972
  • Fax:
Mailing address:
  • Phone: 479-685-2972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRCP-3131
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: