Provider Demographics
NPI:1427836253
Name:HOLLOWAY, AARONANDA
Entity type:Individual
Prefix:DR
First Name:AARONANDA
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W BROWN DEER RD STE G
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2370
Mailing Address - Country:US
Mailing Address - Phone:414-839-3806
Mailing Address - Fax:
Practice Address - Street 1:333 W BROWN DEER RD STE G
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:WI
Practice Address - Zip Code:53217-2370
Practice Address - Country:US
Practice Address - Phone:414-839-3806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver