Individual
HOLLY JEANETTE JACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4301 W MARKHAM ST # 515, LITTLE ROCK, AR 72205-7101
(501) 686-6114
(501) 686-8139
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-7000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R73609
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C02918
AR
Other
Enumeration date
03/08/2012
Last updated
05/30/2023
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