Healthcare Provider Details

I. General information

NPI: 1437856820
Provider Name (Legal Business Name): SAKINAH A. SHAW APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 CENTRAL AVE STE F
HOT SPRINGS AR
71901-6898
US

IV. Provider business mailing address

1820 CENTRAL AVE STE F
HOT SPRINGS AR
71901-6898
US

V. Phone/Fax

Practice location:
  • Phone: 833-479-4325
  • Fax: 833-464-3107
Mailing address:
  • Phone: 833-479-4325
  • Fax: 833-464-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number222060
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number222060
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: