Provider Demographics
NPI:1790676690
Name:SHIPLEY-BOLANIS, ROSSELVY ARELI (DNP FNP-BC)
Entity type:Individual
Prefix:
First Name:ROSSELVY
Middle Name:ARELI
Last Name:SHIPLEY-BOLANIS
Suffix:
Gender:F
Credentials:DNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 SR 124
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-1286
Mailing Address - Country:US
Mailing Address - Phone:479-970-3754
Mailing Address - Fax:
Practice Address - Street 1:106 WEIR RD STE 4
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72802-9409
Practice Address - Country:US
Practice Address - Phone:479-280-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR234090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily