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General NPI Number Information
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NPI Number | 1043851124
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Entity Type | Individual
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Provider Name | HARLEIGH HOLLERN PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 225 E STATE ROUTE 14 STE 102
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City | COLUMBIANA
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State | OH
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Zip | 44408-8490
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Country | US
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Telephone | 330-965-5046
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Fax |
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Provider Business Mailing Address
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Address Line | 496 E GRANT ST
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City | EAST PALESTINE
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State | OH
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Zip | 44413-2304
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Country | US
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Telephone | 330-921-8851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA060809
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License Number State | PA
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