Healthcare Provider Details

I. General information

NPI: 1962644831
Provider Name (Legal Business Name): HOLLY IVALON GERMAN N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY IVALON ELMORE GERMANN N.D.

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 W DRAKE RD STE 210
FORT COLLINS CO
80526
US

IV. Provider business mailing address

2807 CRYSTAL CT
FORT COLLINS CO
80525-2317
US

V. Phone/Fax

Practice location:
  • Phone: 970-833-1202
  • Fax:
Mailing address:
  • Phone: 832-330-3522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberND360
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberND147
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: