Individual
STACI L HOLLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8424 NAAB RD STE 1L, INDIANAPOLIS, IN 46260-1954
(317) 338-7780
Mailing address
8424 NAAB RD STE 1L, INDIANAPOLIS, IN 46260-1954
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01076248A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01076248A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2012
Last updated
06/30/2022
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