Provider Demographics
NPI:1316360191
Name:MCADAMS, HOLLY D (APRN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:D
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:D
Other - Last Name:GOODIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2708 RIFE MEDICAL LANE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758
Mailing Address - Country:US
Mailing Address - Phone:479-338-3888
Mailing Address - Fax:479-338-4445
Practice Address - Street 1:2708 RIFE MEDICAL LANE
Practice Address - Street 2:SUITE 210
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758
Practice Address - Country:US
Practice Address - Phone:479-338-3888
Practice Address - Fax:479-338-4445
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily