Healthcare Provider Details
I. General information
NPI: 1003352444
Provider Name (Legal Business Name): ASHLEY DAWN SHRIVES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/09/2017
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11720 SR 27
HECTOR AR
72843-8712
US
IV. Provider business mailing address
PO BOX 497
AUGUSTA AR
72006-0497
US
V. Phone/Fax
- Phone: 479-284-2127
- Fax: 479-284-2130
- Phone: 870-347-2534
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | A004979 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | A004979 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: