Provider Demographics
NPI:1689983660
Name:DAVIS, SHELYN Y (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SHELYN
Middle Name:Y
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-3502
Mailing Address - Country:US
Mailing Address - Phone:501-332-2101
Mailing Address - Fax:501-337-9532
Practice Address - Street 1:110 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-3502
Practice Address - Country:US
Practice Address - Phone:501-332-2101
Practice Address - Fax:501-337-9532
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist