Individual
HOLLY STOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10728 SHELTON RD, BASTROP, LA 71220-7570
(318) 351-0994
Mailing address
10728 SHELTON RD, BASTROP, LA 71220-7570
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201605801RN
OR
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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