Healthcare Provider Details

I. General information

NPI: 1033849765
Provider Name (Legal Business Name): SHALYN BREH CALAWAY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST # 518
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

101 DEAUVILLE DR
MAUMELLE AR
72113-7212
US

V. Phone/Fax

Practice location:
  • Phone: 501-526-0500
  • Fax: 501-526-5892
Mailing address:
  • Phone: 870-897-6193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number220717
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number220717
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: