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Individual

MALLORY DENAE HOELZEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3010 FOUNTAIN DR, CONWAY, AR 72034-3684
(501) 328-0055
(501) 328-2194
Mailing address
3010 FOUNTAIN DR, CONWAY, AR 72034-3684
(501) 328-0055
(501) 328-2194

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
120120
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120120
ARKANSAS NURSE PRACTITIONER LICENSE
AR
01
F06190767
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
Enumeration date
06/11/2019
Last updated
06/11/2019
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