Basic Information
| Provider Information | |||||||||
| NPI: | 1639457351 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISHER | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 252 MANOR ST | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723641936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707396818 | ||||||||
| FaxNumber: | 8707396821 | ||||||||
| Practice Location | |||||||||
| Address1: | 1825 E BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723353409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8706302328 | ||||||||
| FaxNumber: | 8706302348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2011 | ||||||||
| LastUpdateDate: | 07/29/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | R66223 | AR | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.