Provider Demographics
NPI:1285079392
Name:HELLER, HOLLY L (CD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:L
Last Name:HELLER
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7856 PEGGY LN
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-8709
Mailing Address - Country:US
Mailing Address - Phone:850-288-2957
Mailing Address - Fax:
Practice Address - Street 1:7856 PEGGY LN
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32583-8709
Practice Address - Country:US
Practice Address - Phone:850-288-2957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula