Individual
HOLLY P. DE LA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 CITY HILL DR, LONDON, KY 40741-3038
(606) 878-6633
Mailing address
939 SASSER SCHOOL RD, LONDON, KY 40744-8486
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1028899
KY
Other
Enumeration date
03/15/2007
Last updated
11/16/2011
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