Provider Demographics
NPI:1700646775
Name:WILLIAMS, HOLLY GRACE (PHARMD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:GRACE
Last Name:WILLIAMS
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 1:35 W UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1668
Mailing Address - Country:US
Mailing Address - Phone:731-984-9782
Mailing Address - Fax:
Practice Address - Street 1:35 W UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1668
Practice Address - Country:US
Practice Address - Phone:731-984-9782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist