Provider Demographics
NPI:1710619713
Name:OWENS, HOLLY DIAL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:DIAL
Last Name:OWENS
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 1:1212 LAUREL ST APT 713
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5572
Mailing Address - Country:US
Mailing Address - Phone:731-363-1932
Mailing Address - Fax:
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-4400
Practice Address - Country:US
Practice Address - Phone:615-284-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist