Healthcare Provider Details

I. General information

NPI: 1346309358
Provider Name (Legal Business Name): AARON FRANKLIN HOLLOWAY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N MAIN ST
OPP AL
36467-1626
US

IV. Provider business mailing address

401 OAKWOOD DR
OPP AL
36467-9765
US

V. Phone/Fax

Practice location:
  • Phone: 334-493-3541
  • Fax: 334-493-9664
Mailing address:
  • Phone: 334-804-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-077898
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: