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General NPI Number Information
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NPI Number | 1114319605
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Entity Type | Individual
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Provider Name | DIANA HOLTE APRN
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Gender | Female
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 3729 N CROSSOVER RD STE 107
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5538
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Country | US
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Telephone | 479-595-8676
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Fax | 479-935-8984
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Provider Business Mailing Address
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Address Line | 614 E EMMA AVE STE 300
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City | SPRINGDALE
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State | AR
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Zip | 72764-4469
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Country | US
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Telephone | 479-751-7417
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Fax | 479-751-4898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A004336
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License Number State | AR
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