Healthcare Provider Details

I. General information

NPI: 1285802280
Provider Name (Legal Business Name): HOLLY JANICE SEE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WALNUT ST
FRANKLIN WV
26807
US

IV. Provider business mailing address

HC 62 BOX 60B
UPPER TRACT WV
26866-9713
US

V. Phone/Fax

Practice location:
  • Phone: 304-358-2207
  • Fax:
Mailing address:
  • Phone: 304-358-3182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number55897
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: