Healthcare Provider Details

I. General information

NPI: 1922622406
Provider Name (Legal Business Name): HOLLY CAMILLE HOWARD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOLBROOK ST STE 2
DANVILLE VA
24541-1760
US

IV. Provider business mailing address

101 HOLBROOK ST STE 2
DANVILLE VA
24541-1760
US

V. Phone/Fax

Practice location:
  • Phone: 434-792-7765
  • Fax: 434-793-4061
Mailing address:
  • Phone: 434-792-7765
  • Fax: 434-793-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102208030
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: