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Individual

CONNIE J HOLLADAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.C.

Contact information

Practice address
438 E. VANN ROAD, SUITE 100, GREENEVILLE, TN 37743-7202
(423) 278-1700
(423) 278-1712
Mailing address
PO BOX 37087, BALTIMORE, MD 21297-3807
(828) 687-6282
(828) 687-6285

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD15684
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018811
MS
05
1518493
TN
01
4009043
BCBS OF TN
TN
Enumeration date
07/10/2006
Last updated
10/18/2010
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