Provider Demographics
NPI:1134672629
Name:PENDEL, HOLLY N (OD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:N
Last Name:PENDEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 IRIS LN
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-7528
Mailing Address - Country:US
Mailing Address - Phone:931-456-2728
Mailing Address - Fax:931-456-5446
Practice Address - Street 1:802 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1722
Practice Address - Country:US
Practice Address - Phone:931-400-5154
Practice Address - Fax:931-400-5155
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD3496152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist