NPI 1104662253

Jennifer N/A McShane

Practitioner Driver Maumelle, AR

Practice location

Address: PO Box 13166, Maumelle, AR 72113-0166
Phone: (501) 508-1404

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1104662253
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Jul 2024
Record last updated: 8 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.