Provider Demographics
NPI:1598060451
Name:FLETCHER, HOLLIE SHELTON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HOLLIE
Middle Name:SHELTON
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 SEABREEZE LN
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3339
Mailing Address - Country:US
Mailing Address - Phone:706-313-3387
Mailing Address - Fax:
Practice Address - Street 1:1177 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4835
Practice Address - Country:US
Practice Address - Phone:850-677-9340
Practice Address - Fax:850-677-9087
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist