Provider Demographics
NPI:1114319605
Name:HOLTE, DIANA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:HOLTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3729 N CROSSOVER RD STE 107
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5538
Mailing Address - Country:US
Mailing Address - Phone:479-595-8676
Mailing Address - Fax:
Practice Address - Street 1:3729 N CROSSOVER RD STE 107
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5538
Practice Address - Country:US
Practice Address - Phone:479-595-8676
Practice Address - Fax:479-935-8984
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily