Healthcare Provider Details

I. General information

NPI: 1982176335
Provider Name (Legal Business Name): SHAWNTE FARMER PSYCHIATRIC SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 S MARKET ST
ROGERS AR
72758-8197
US

IV. Provider business mailing address

11401 N RODNEY PARHAM RD STE 4
LITTLE ROCK AR
72212-4168
US

V. Phone/Fax

Practice location:
  • Phone: 479-366-0850
  • Fax:
Mailing address:
  • Phone: 501-223-9948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHAWNTE FARMER
Title or Position: OWNER
Credential:
Phone: 479-855-5704