Provider Demographics
NPI:1699188474
Name:NEARY, HOLLY (RPH)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:NEARY
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 1:5375 ORTEGA FARMS BLVD
Mailing Address - Street 2:#807
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-7461
Mailing Address - Country:US
Mailing Address - Phone:904-263-2709
Mailing Address - Fax:
Practice Address - Street 1:5375 ORTEGA FARMS BLVD
Practice Address - Street 2:#807
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-7461
Practice Address - Country:US
Practice Address - Phone:904-263-2709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH45865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist