Individual
JONATHAN HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
F-NP
Contact information
Practice address
1525 W CARO RD, CARO, MI 48723-9686
(989) 672-2100
Mailing address
1525 W CARO RD, CARO, MI 48723-9686
(989) 672-2100
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704290748
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659326395
—
MI
05
—
1689022469
—
MI
Enumeration date
03/28/2016
Last updated
02/07/2019
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