Provider Demographics
NPI:1548606361
Name:SHOOK, ELIZABETH JEAN (RNP, CS, APN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JEAN
Last Name:SHOOK
Suffix:
Gender:F
Credentials:RNP, CS, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 OAKBROOK RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-9157
Mailing Address - Country:US
Mailing Address - Phone:501-831-2751
Mailing Address - Fax:
Practice Address - Street 1:5510 OAKBROOK RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:AR
Practice Address - Zip Code:72002-9157
Practice Address - Country:US
Practice Address - Phone:501-831-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR19094163WG0600X
ARP01308163WG0600X
ARS01065163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology