Provider Demographics
NPI:1891020335
Name:FRANDSEN, HOLLY (RPH)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:FRANDSEN
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 1:2115 US HIGHWAY 60 STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:AZ
Mailing Address - Zip Code:85539-8744
Mailing Address - Country:US
Mailing Address - Phone:928-425-8165
Mailing Address - Fax:928-425-2553
Practice Address - Street 1:2115 US HIGHWAY 60 STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:AZ
Practice Address - Zip Code:85539-8744
Practice Address - Country:US
Practice Address - Phone:928-425-8165
Practice Address - Fax:928-425-2553
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist