Provider Demographics
NPI:1548403736
Name:DRISKELL, HOLLEY ANN (RRT)
Entity Type:Individual
Prefix:
First Name:HOLLEY
Middle Name:ANN
Last Name:DRISKELL
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 NW WESLEY CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4232
Mailing Address - Country:US
Mailing Address - Phone:305-301-4416
Mailing Address - Fax:
Practice Address - Street 1:5575 NW WESLEY CT
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4232
Practice Address - Country:US
Practice Address - Phone:305-301-4416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT9191227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRT9191OtherRESPIRATORY THERAPIST