Individual
NICOLE ANNETTE HOLYFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
53 RIVERSIDE DR, FAIRMONT, WV 26554-5764
(304) 844-2432
Mailing address
65 PROFESSIONAL PL FL 1, BRIDGEPORT, WV 26330-0258
(304) 848-5770
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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