Provider Demographics
NPI:1215013289
Name:HOLLEY, SHERRI (LM, CPM)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:
Last Name:HOLLEY
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 EAST MAIN
Mailing Address - Street 2:SUITE F #164
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-5157
Mailing Address - Country:US
Mailing Address - Phone:505-327-4532
Mailing Address - Fax:
Practice Address - Street 1:3705 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-8723
Practice Address - Country:US
Practice Address - Phone:505-327-4532
Practice Address - Fax:505-327-7699
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM96389R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife