Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | DR.0061032 | CO |
NPI | 1003357369 |
---|---|
Provider Name | Dr. Hailey Holland |
First Address | Westminster, CO 80023-9206 |
Second Address | Westminster, CO 80023-9206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2017 |
Last Update Date | 21/07/2020 |