Provider Demographics
NPI:1619561149
Name:HOLLAND, JOANMARIE (RPH)
Entity Type:Individual
Prefix:
First Name:JOANMARIE
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2159
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2159
Mailing Address - Country:US
Mailing Address - Phone:606-478-9474
Mailing Address - Fax:606-478-1000
Practice Address - Street 1:11155 US HWY 23 S
Practice Address - Street 2:
Practice Address - City:BETSY LAYNE
Practice Address - State:KY
Practice Address - Zip Code:41605
Practice Address - Country:US
Practice Address - Phone:160-647-8947
Practice Address - Fax:606-478-1000
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist