Provider Demographics
NPI:1851885701
Name:HOLLARS, ALICIA LESLIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:LESLIE
Last Name:HOLLARS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3398 S 700 E
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-9555
Mailing Address - Country:US
Mailing Address - Phone:765-618-3765
Mailing Address - Fax:
Practice Address - Street 1:121 E HIGH ST
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:IN
Practice Address - Zip Code:47359-1105
Practice Address - Country:US
Practice Address - Phone:765-728-2421
Practice Address - Fax:765-728-8564
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71008039A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily