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General NPI Number Information
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NPI Number | 1417461989
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Entity Type | Individual
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Provider Name | HOLLY E DIAL APRN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 10/22/2026
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Provider Practice Location Address
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Address Line | 407 S GOULD AVE
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City | GOULD
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State | AR
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Zip | 71643-5041
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Country | US
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Telephone | 870-382-3080
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Fax | 870-263-4782
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Provider Business Mailing Address
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Address Line | 923 AUTUMN HILLS RD
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City | STAR CITY
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State | AR
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Zip | 71667-9884
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Country | US
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Telephone | 870-370-8032
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Fax |
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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 | 212545
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License Number State | AR
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