Provider Demographics
NPI:1881086148
Name:ROGERS, HOLLY (MSN)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:ABELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN
Mailing Address - Street 1:PO BOX 1523
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-1523
Mailing Address - Country:US
Mailing Address - Phone:479-571-6038
Mailing Address - Fax:479-582-0222
Practice Address - Street 1:3344 N FUTRALL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4061
Practice Address - Country:US
Practice Address - Phone:479-582-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily