Provider Demographics
NPI:1699252452
Name:PELA, HOLLY ELLEN (WHNP-BC, DNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ELLEN
Last Name:PELA
Suffix:
Gender:F
Credentials:WHNP-BC, DNP
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ELLEN
Other - Last Name:MARIETTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9232 N CAMINO VISTA LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-4816
Mailing Address - Country:US
Mailing Address - Phone:602-488-3343
Mailing Address - Fax:
Practice Address - Street 1:8415 N PIMA RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4480
Practice Address - Country:US
Practice Address - Phone:480-434-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11555207V00000X, 207VE0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty