Provider Demographics
NPI:1497440457
Name:OBCEMANE, HOLYANNA (CPHT)
Entity Type:Individual
Prefix:MS
First Name:HOLYANNA
Middle Name:
Last Name:OBCEMANE
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 VOLVO PKWY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-7654
Mailing Address - Country:US
Mailing Address - Phone:757-436-9157
Mailing Address - Fax:
Practice Address - Street 1:1201 VOLVO PKWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-7654
Practice Address - Country:US
Practice Address - Phone:757-436-9157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230022149183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician