Healthcare Provider Details

I. General information

NPI: 1023161171
Provider Name (Legal Business Name): HOLLE GARVEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CAREW ST
SPRINGFIELD MA
01104-2377
US

IV. Provider business mailing address

15 WIESER DR
WESTFIELD MA
01085-5130
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-9064
  • Fax:
Mailing address:
  • Phone: 413-534-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number216691
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: