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NPI Code Detail

MEDICARE: HOLLY ENDRES

MEDICARE:   HOLLY  ENDRES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246Z00000XOther Specialist/TechnologistOH3040657OH

General Provider Information

NPI Number : 1396617858
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY ENDRES
Provider Business Mailing Address
First Line : 3595 WASHINGTON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-2617
Country : US
Telephone Number : 513-351-5801
Fax Number :
Provider Business Practice Location Address
First Line : 3595 WASHINGTON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-2617
Country : US
Telephone Number : 513-351-5801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2025
Last Update Date : 09/23/2025

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Directions to “ HOLLY ENDRES ” Practice Location

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