Healthcare Provider Details

I. General information

NPI: 1063977528
Provider Name (Legal Business Name): HOLLEN FAMILY MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 E BELTLINE AVE NE STE 102
GRAND RAPIDS MI
49525-4598
US

IV. Provider business mailing address

1525 E BELTLINE AVE NE STE 102
GRAND RAPIDS MI
49525-4598
US

V. Phone/Fax

Practice location:
  • Phone: 616-363-0055
  • Fax: 616-363-5180
Mailing address:
  • Phone: 616-363-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRITTANNY SNOW
Title or Position: PRACTICE MANAGER
Credential:
Phone: 616-363-0055