Basic Information
| Provider Information | |||||||||
| NPI: | 1407170806 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHELDEN | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 510 | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725600510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702694361 | ||||||||
| FaxNumber: | 8702693093 | ||||||||
| Practice Location | |||||||||
| Address1: | 2106 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725606439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702694361 | ||||||||
| FaxNumber: | 8702693093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2010 | ||||||||
| LastUpdateDate: | 03/15/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 16964 | AR | Y | Nursing Service Providers | Registered Nurse |
No ID Information.