Healthcare Provider Details

I. General information

NPI: 1811404551
Provider Name (Legal Business Name): SHELBI LYNN SLOAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 PROGRESS WAY STE 501
BRYANT AR
72022-9282
US

IV. Provider business mailing address

107 PROGRESS WAY SUITE 501
LITTLE ROCK AR
72223-3000
US

V. Phone/Fax

Practice location:
  • Phone: 602-809-8630
  • Fax: 602-532-7166
Mailing address:
  • Phone: 602-809-8630
  • Fax: 602-532-7166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA005350
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: