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NPI Code Detail

MEDICARE: SHALON HOLLOWAY CASE MANAGER

MEDICARE: SHALON HOLLOWAY CASE MANAGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1851417588
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALON HOLLOWAY CASE MANAGER
Provider Business Mailing Address
First Line : 110 SKYLINE DR
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-3362
Country : US
Telephone Number : 479-967-5570
Fax Number : 479-890-5364
Provider Business Practice Location Address
First Line : 350 SALEM RD STE 1
Second Line :
City : CONWAY
State : AR
Zip : 72034-6166
Country : US
Telephone Number : 501-336-8300
Fax Number : 501-329-5508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 07/08/2007

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