Healthcare Provider Details

I. General information

NPI: 1407195324
Provider Name (Legal Business Name): SHENA R. RANON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 S RIFE MEDICAL LANE SUITE 300
ROGERS AR
72758
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 863-604-6537
  • Fax:
Mailing address:
  • Phone: 479-338-3030
  • Fax: 479-338-3079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number229842
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: