Provider Demographics
NPI:1679583918
Name:HOLLINGSWORTH, MOLLY O (RNP)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:O
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 CENTRAL AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6404
Mailing Address - Country:US
Mailing Address - Phone:501-623-6693
Mailing Address - Fax:501-623-9403
Practice Address - Street 1:3633 CENTRAL AVE
Practice Address - Street 2:SUITE D
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6404
Practice Address - Country:US
Practice Address - Phone:501-623-6693
Practice Address - Fax:501-623-9403
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP01361363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARR01361Medicare UPIN
ARP00804717Medicare PIN