Provider Demographics
NPI:1386868768
Name:COLLIER, HOLLY (NP)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:PHILPOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1088 BAXTER ST # A
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6316
Mailing Address - Country:US
Mailing Address - Phone:706-353-0606
Mailing Address - Fax:706-353-0798
Practice Address - Street 1:1088 BAXTER ST STE A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6316
Practice Address - Country:US
Practice Address - Phone:706-353-0606
Practice Address - Fax:706-353-0798
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN129070NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBHTXMedicare ID - Type Unspecified
GAQ27611Medicare UPIN