Individual
VINCENT WILLIAM HOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, APRN, CNS
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 353-5593
Mailing address
8790 N FISH RD, BLOOMINGTON, IN 47408-9236
(812) 219-2791
Taxonomy
Speciality
Code
Description
License number
State
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
Primary
28133098A
IN
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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