Provider Demographics
NPI:1255640256
Name:CULLOP, HOLLY NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:NICOLE
Last Name:CULLOP
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 1:130 CHAD WAYNE DR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-4439
Mailing Address - Country:US
Mailing Address - Phone:859-333-5304
Mailing Address - Fax:
Practice Address - Street 1:928 S 12TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2949
Practice Address - Country:US
Practice Address - Phone:270-753-1272
Practice Address - Fax:270-759-5257
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-25
Last Update Date:2010-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist