Healthcare Provider Details

I. General information

NPI: 1699252452
Provider Name (Legal Business Name): HOLLY ELLEN PELA WHNP-BC, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HOLLY ELLEN MARIETTA

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 N PIMA RD
SCOTTSDALE AZ
85258-4480
US

IV. Provider business mailing address

9232 N CAMINO VISTA LN
PHOENIX AZ
85028-4816
US

V. Phone/Fax

Practice location:
  • Phone: 480-434-6565
  • Fax:
Mailing address:
  • Phone: 602-488-3343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberAP11555
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberAP11555
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP11555
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: