=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174411623
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOLLY DOWDY EARLES FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2025
-----------------------------------------------------
Last Update Date | 09/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1009 OLD COUNTRY CLUB RD NW
-----------------------------------------------------
City | ROANOKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24017-2927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-235-1940
-----------------------------------------------------
Fax | 540-276-6833
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5082 THORNSPRING RD
-----------------------------------------------------
City | PULASKI
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24301-7032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-235-1940
-----------------------------------------------------
Fax | 540-276-6833
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 0024193887
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------