Provider Demographics
NPI:1629855630
Name:HARBER, HOLLY RENEE
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:RENEE
Last Name:HARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 E 99TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-5501
Mailing Address - Country:US
Mailing Address - Phone:316-322-0768
Mailing Address - Fax:
Practice Address - Street 1:6925 S CANTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3418
Practice Address - Country:US
Practice Address - Phone:918-932-8164
Practice Address - Fax:314-375-8570
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula