Healthcare Provider Details

I. General information

NPI: 1881519403
Provider Name (Legal Business Name): HOLLY ALEXANDRA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16-1363 UAU ROAD
MOUNTAIN VIEW HI
96771
US

IV. Provider business mailing address

15-2714 PAHOA VILLAGE ROAD STE H1 PMB 336
PAHOA HI
96778
US

V. Phone/Fax

Practice location:
  • Phone: 530-368-9189
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number110030
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: