Provider Demographics
NPI:1316677230
Name:HOLLOWOA, KATIE (APRN)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:HOLLOWOA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2435
Mailing Address - Fax:870-301-2092
Practice Address - Street 1:501 MILLWOOD CIR STE E
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6304
Practice Address - Country:US
Practice Address - Phone:501-803-9990
Practice Address - Fax:501-803-9991
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR105264163W00000X
AR220655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse