Provider Demographics
NPI:1417192774
Name:ARNOLD, SHEA S (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SHEA
Middle Name:S
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SHEA
Other - Middle Name:AMBER
Other - Last Name:SALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2708 S RIFE MEDICAL LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:479-338-3030
Mailing Address - Fax:479-338-3079
Practice Address - Street 1:2708 S RIFE MEDICAL LN
Practice Address - Street 2:SUITE 300
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-3030
Practice Address - Fax:479-338-3079
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-328363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical