Individual
RYAN HOLLEY - MALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-C
Contact information
Practice address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
(248) 660-1220
Mailing address
100 CHERRY ST SE # MC845, GRAND RAPIDS, MI 49503-4526
(616) 965-8209
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704259565
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704259565
MI
Other
Enumeration date
04/05/2011
Last updated
03/28/2025
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