Individual
HOLLY EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2300 GRANDE BLVD SE # 4045, RIO RANCHO, NM 87124-1755
(505) 896-7100
Mailing address
2300 GRANDE BLVD SE, RIO RANCHO, NM 87124-1755
(505) 896-7100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2020-0016
NM
Other
Enumeration date
02/12/2020
Last updated
03/14/2025
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