Provider Demographics
NPI:1083086953
Name:SHUFFIELD, KERRY
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:
Last Name:SHUFFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 HIGDON FERRY RD STE B
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6904
Mailing Address - Country:US
Mailing Address - Phone:501-525-4688
Mailing Address - Fax:501-525-4662
Practice Address - Street 1:1635 HIGDON FERRY RD STE B
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6904
Practice Address - Country:US
Practice Address - Phone:501-525-4688
Practice Address - Fax:501-525-4662
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR632237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist