Provider Demographics
NPI:1114693363
Name:CALLAWAY, HOLLY MARIE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MARIE
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2700 HIGHWAY 280 S STE 212
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2468
Mailing Address - Country:US
Mailing Address - Phone:205-878-4368
Mailing Address - Fax:205-878-4367
Practice Address - Street 1:2700 HIGHWAY 280 S STE 212
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2468
Practice Address - Country:US
Practice Address - Phone:205-878-4368
Practice Address - Fax:205-878-4367
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-184909363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology