Healthcare Provider Details

I. General information

NPI: 1407749583
Provider Name (Legal Business Name): HOLLY M MAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS HOLLY BOWMAN

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 NE 10TH AVE
PAYETTE ID
83661-5420
US

IV. Provider business mailing address

1441 NE 10TH AVE
PAYETTE ID
83661-5420
US

V. Phone/Fax

Practice location:
  • Phone: 615-962-1520
  • Fax:
Mailing address:
  • Phone: 208-642-9376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA226339
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9271657
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: