Individual
MICAHL HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7201 W 25TH AVE, GARY, IN 46406-2940
(219) 979-2026
Mailing address
7201 W 25TH AVE, GARY, IN 46406-2940
(219) 979-2026
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28199983A
IN
363LF0000X
Family Nurse Practitioner
71012573A
IN
Other
Enumeration date
03/03/2022
Last updated
08/16/2024
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