Healthcare Provider Details

I. General information

NPI: 1881422590
Provider Name (Legal Business Name): SHAYLA WINKEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 W CHESTNUT ST
ROGERS AR
72756-0351
US

IV. Provider business mailing address

405 QUAIL RUN
ELM SPRINGS AR
72762-5278
US

V. Phone/Fax

Practice location:
  • Phone: 479-246-0101
  • Fax:
Mailing address:
  • Phone: 479-366-4307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4890
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: