1871123968 NPI number — DR. HOLLY JO LANGSTER DNP,FNP-C,HCA,CENP

Table of content: DR. HOLLY JO LANGSTER DNP,FNP-C,HCA,CENP (NPI 1871123968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871123968 NPI number — DR. HOLLY JO LANGSTER DNP,FNP-C,HCA,CENP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANGSTER
Provider First Name:
HOLLY
Provider Middle Name:
JO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP,FNP-C,HCA,CENP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871123968
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 654451
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75265-4451
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-888-8999
Provider Business Mailing Address Fax Number:
281-305-4054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13501 CHENAL PKWY
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72211-5262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-888-8999
Provider Business Practice Location Address Fax Number:
281-305-4054
Provider Enumeration Date:
01/17/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
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Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1871123968 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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