MEDICARE: MRS. KERRY SHUFFIELD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	632	AR

General Provider Information

NPI Number	:	1083086953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KERRY SHUFFIELD

Provider Business Mailing Address
First Line	:	1635 HIGDON FERRY RD STE B
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6904
Country	:	US
Telephone Number	:	501-525-4688
Fax Number	:	501-525-4662

Provider Business Practice Location Address
First Line	:	1635 HIGDON FERRY RD STE B
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6904
Country	:	US
Telephone Number	:	501-525-4688
Fax Number	:	501-525-4662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2015
Last Update Date	:	10/30/2015

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