Individual
SHANE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1401 FORUM BLVD STE 202, COLUMBIA, MO 65203-1915
(573) 234-1367
Mailing address
1401 FORUM BLVD STE 202, COLUMBIA, MO 65203-1915
(573) 234-1367
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2016044506
MO
Other
Enumeration date
01/09/2017
Last updated
12/15/2022
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