Individual
NICKI MARIE HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2135 N WEST AVE, EL DORADO, AR 71730-3351
(870) 862-5458
Mailing address
2135 N WEST AVE, EL DORADO, AR 71730-3351
(870) 862-5458
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD14058
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
479466
NABP
—
01
—
PD14058
ARKANSAS STATE BOARD OF PHARMACY
AR
Enumeration date
12/11/2017
Last updated
06/16/2018
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