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General NPI Number Information
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NPI Number | 1851001606
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Entity Type | Individual
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Provider Name | HOLLY MARIE TAYLOR PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 2955 CHURCH RD E
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9767
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Country | US
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Telephone | 662-349-7375
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Fax |
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Provider Business Mailing Address
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Address Line | 544 GOLDEN RD
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City | COLDWATER
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State | MS
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Zip | 38618-7411
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Country | US
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Telephone | 662-671-4515
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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 | E-100797
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License Number State | MS
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