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General NPI Number Information
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NPI Number | 1467055954
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Entity Type | Individual
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Provider Name | KIMBERLY MARIE HOLLON
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Gender | Female
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1410 E DOROTHY LN
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City | KETTERING
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State | OH
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Zip | 45429-3806
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Country | US
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Telephone | 937-294-0535
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Fax |
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Provider Business Mailing Address
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Address Line | 7009 SPRUCE HILL CIR
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City | WEST CHESTER
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State | OH
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Zip | 45069-3638
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Country | US
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Telephone | 513-604-6156
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 00321337
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License Number State | OH
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