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HOLLEY SHELTON APN-NP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1629337738
Individual Registrant: HOLLEY SHELTON APN-NP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
110 N DREW STAR CITY, AR 71667 US
Tel: 870-628-5110 Fax: 870-854-6281
Tel: 870-628-5110 Fax: 870-854-6281
Contact information for business:
PO BOX 509 DERMOTT, AR 71638 US
Tel: 870-538-5414 Fax: 870-538-5412
Tel: 870-538-5414 Fax: 870-538-5412
Registration Information:
NPI: 1629337738
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | AR | A03687 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| STATE LICENSE | A03687 | AR | 01 |
| NPI | 162933738 | AR | 01 |
