Provider Demographics
NPI:1336331016
Name:STRUM, HOLLY MICHELE
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MICHELE
Last Name:STRUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MICHELE
Other - Last Name:SHERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4708 S COBIA WAY
Mailing Address - Street 2:
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-9520
Mailing Address - Country:US
Mailing Address - Phone:252-423-0983
Mailing Address - Fax:
Practice Address - Street 1:4708 S COBIA WAY
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9520
Practice Address - Country:US
Practice Address - Phone:252-423-0983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist