Provider Demographics
NPI:1962644831
Name:GERMAN, HOLLY IVALON (ND)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:IVALON
Last Name:GERMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:IVALON
Other - Last Name:ELMORE GERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:2807 CRYSTAL CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2317
Mailing Address - Country:US
Mailing Address - Phone:832-330-3522
Mailing Address - Fax:
Practice Address - Street 1:313 W DRAKE RD STE 210
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526
Practice Address - Country:US
Practice Address - Phone:970-833-1202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND360207QA0505X
COND147207QA0505X
175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine