Individual
MRS. SANDRA HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 BETHANY ST, SPARKS, GA 31647-7139
(229) 237-6052
Mailing address
607 BETHANY ST, SPARKS, GA 31647-7139
(229) 237-6052
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN158478
GA
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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