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General NPI Number Information
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NPI Number | 1639822828
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Entity Type | Organization
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Legal Business Name | KNEW MINDSET LLC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 02/24/2024
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Provider Practice Location Address
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Address Line | 944 STATE HIGHWAY 77
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City | MARION
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State | AR
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Zip | 72364-9004
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Country | US
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Telephone | 870-821-0315
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1530
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City | MARION
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State | AR
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Zip | 72364-1539
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Country | US
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Telephone | 870-559-9144
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JALEESA SHEARS
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Credential | DNP, APRN
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Telephone | 870-559-9144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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