MEDICARE: JULIE SHIELDS RN

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	163W00000X	Registered Nurse	R056041	AR

General Provider Information

NPI Number	:	1851226336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE SHIELDS RN

Provider Business Mailing Address
First Line	:	2708 S RIFE MEDICAL LN
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-9122
Country	:	US
Telephone Number	:	479-338-4400
Fax Number	:	479-338-4400

Provider Business Practice Location Address
First Line	:	2708 S RIFE MEDICAL LN
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-9122
Country	:	US
Telephone Number	:	479-338-4400
Fax Number	:	479-338-4400

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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