Provider Demographics
NPI:1487221537
Name:HOLLOWAY, ARIELLE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 DAVE WARD DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-7145
Mailing Address - Country:US
Mailing Address - Phone:501-209-4040
Mailing Address - Fax:501-205-1776
Practice Address - Street 1:655 DAVE WARD DR STE 103
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-7145
Practice Address - Country:US
Practice Address - Phone:501-209-4040
Practice Address - Fax:501-205-1776
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR104399163W00000X
AR216223363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse