Individual
MARIAH HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2426 W CORNERSTONE CT STE 100, PEORIA, IL 61614-2400
(309) 966-3137
Mailing address
232 W PINE ST, CANTON, IL 61520-2435
(309) 224-0607
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209024007
IL
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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