Provider Demographics
NPI:1790994630
Name:MACARTHUR, HOLLY DAWN (ARNP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:DAWN
Last Name:MACARTHUR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SAINT JOHNSBURY RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3442
Mailing Address - Country:US
Mailing Address - Phone:603-444-9565
Mailing Address - Fax:
Practice Address - Street 1:90 SWIFTWATER RD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-1421
Practice Address - Country:US
Practice Address - Phone:603-747-3668
Practice Address - Fax:603-747-3024
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH044044-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1790994630OtherANTHEM BLUE CROSS
4158699OtherMVP
NH30345259Medicaid
NH40Y012353NH02OtherANTHEM
201966920OtherTRICARE
VT1014053Medicaid
620955OtherCIGNA
7418962OtherAETNA
VT1014053Medicaid
NH6058360001Medicare NSC