Provider Demographics
NPI:1194071381
Name:ABDEL NOUR, HOLLY MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARIE
Last Name:ABDEL NOUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:CORNER OF LAMONT AND VETERANS WAY
Mailing Address - Street 2:JAMES H. QUILLEN VA MEDICAL CENTER
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684
Mailing Address - Country:US
Mailing Address - Phone:423-926-1171
Mailing Address - Fax:
Practice Address - Street 1:CORNER OF LAMONT AND VETERANS WAY
Practice Address - Street 2:JAMES H. QUILLEN VA MEDICAL CENTER
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist