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NPI Code Detail

MEDICARE: DR. MICHELE MONIQUE HOLLEY MD

MEDICARE: DR. MICHELE MONIQUE HOLLEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianL4974TX
2207L00000XAnesthesiology Physician36011AZ

General Provider Information

NPI Number : 1982686580
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELE MONIQUE HOLLEY MD
Provider Business Mailing Address
First Line : PO BOX 7096
Second Line :
City : STOCKTON
State : CA
Zip : 95267-0096
Country : US
Telephone Number : 209-956-7725
Fax Number : 209-956-7733
Provider Business Practice Location Address
First Line : 2735 SILVER CREEK ROAD
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-7942
Country : US
Telephone Number : 928-763-2273
Fax Number : 928-763-0223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 04/22/2015

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Directions to “ DR. MICHELE MONIQUE HOLLEY MD” Practice Location

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