Individual
HOLLY BERRYMAN BACKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1216 SOMERVILLE RD SE, DECATUR, AL 35601-4335
(256) 340-0012
(256) 340-1408
Mailing address
2301 DOGWOOD LN SE, DECATUR, AL 35601-5317
(256) 476-2295
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-139307
AL
Other
Enumeration date
02/19/2020
Last updated
03/16/2020
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