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General NPI Number Information
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NPI Number | 1093699647
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Entity Type | Individual
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Provider Name | SHAWNA MCMINN ARPN, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 4334 E HIGHLAND DR
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City | JONESBORO
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State | AR
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Zip | 72401-6621
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Country | US
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Telephone | 870-207-0421
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Fax | 870-207-0559
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Provider Business Mailing Address
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Address Line | 7762 STATE HIGHWAY V
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City | ARBYRD
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State | MO
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Zip | 63821-9151
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Country | US
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Telephone | 573-559-6560
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Fax | 870-207-0559
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 234274
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License Number State | AR
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