Individual
HOLLY BOHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA MSNA
Contact information
Practice address
3000 MEDICAL CENTER PARKWAY, BENTONVILLE, AR 72712
(479) 530-6649
Mailing address
18802 COPPERMINE RD, ROGERS, AR 72756-8148
(479) 925-7882
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R65511
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C02604 CRNA
AR
Other
Enumeration date
05/10/2006
Last updated
07/16/2010
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