Provider Demographics
NPI:1699421214
Name:PARKER, HOLLY (NBC-HWC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7356
Mailing Address - Country:US
Mailing Address - Phone:202-380-5552
Mailing Address - Fax:
Practice Address - Street 1:1823 WOOD AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7356
Practice Address - Country:US
Practice Address - Phone:202-380-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date: