Provider Demographics
NPI:1063961308
Name:HOLLON, GRETEL E (RN)
Entity type:Individual
Prefix:
First Name:GRETEL
Middle Name:E
Last Name:HOLLON
Suffix:
Gender:F
Credentials:RN
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Other - Last Name:
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Mailing Address - Street 1:601 S EDWIN C MOSES BLVD
Mailing Address - Street 2:SAMARITAN BEHAVIORAL HEALTH INC, 4TH FLOOR NW BLDG
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3424
Mailing Address - Country:US
Mailing Address - Phone:937-734-8333
Mailing Address - Fax:937-734-4343
Practice Address - Street 1:601 S EDWIN C MOSES BLVD
Practice Address - Street 2:SAMARITAN BEHAVIORAL HEALTH, INC.,
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:937-734-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.420425163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)