Provider Demographics
NPI:1154994911
Name:DILLARD, PAULA (APRN)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:DILLARD
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 1:165 JERRY BAKER LN
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-9485
Mailing Address - Country:US
Mailing Address - Phone:870-232-5315
Mailing Address - Fax:870-232-5316
Practice Address - Street 1:165 JERRY BAKER LN
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-9485
Practice Address - Country:US
Practice Address - Phone:870-232-5315
Practice Address - Fax:870-232-5316
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR216744363L00000X
MO2021044727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner