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General NPI Number Information
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NPI Number | 1063977528
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Entity Type | Organization
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Legal Business Name | HOLLEN FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 1525 E BELTLINE AVE NE STE 102
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-4598
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Country | US
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Telephone | 616-363-0055
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Fax | 616-363-5180
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Provider Business Mailing Address
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Address Line | 1525 E BELTLINE AVE NE STE 102
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-4598
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Country | US
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Telephone | 616-363-0055
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | BRITTANNY SNOW
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Credential |
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Telephone | 616-363-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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