Provider Demographics
NPI:1023996600
Name:REYNOLDS, SHELBY ANNE (NP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:ANNE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 BLAND ST
Mailing Address - Street 2:
Mailing Address - City:COTTER
Mailing Address - State:AR
Mailing Address - Zip Code:72626-9764
Mailing Address - Country:US
Mailing Address - Phone:870-577-0545
Mailing Address - Fax:
Practice Address - Street 1:806 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FLIPPIN
Practice Address - State:AR
Practice Address - Zip Code:72634-8668
Practice Address - Country:US
Practice Address - Phone:870-453-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR234700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily