Provider Demographics
NPI:1285989061
Name:HOLLEY, EMILY LAUREN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LAUREN
Last Name:HOLLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 FORT HENRY DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-3228
Mailing Address - Country:US
Mailing Address - Phone:423-247-3124
Mailing Address - Fax:423-247-5907
Practice Address - Street 1:1717 FORT HENRY DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-3228
Practice Address - Country:US
Practice Address - Phone:423-247-3124
Practice Address - Fax:423-247-5907
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist