Most Relevant Information
Provider Data
| NPI Number: | 1003388679 |
| Provider Name: | HOLLY ALLEN AGACNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | RN226149 |
Most Important Dates
| Enumeration Date: | 12/20/2018 |
| Last Updated: | 12/20/2019 |
Provider Practice Location
460 NORTHSIDE CHEROKEE BLVD STE 100
CANTON
GA
301158017
Practice Location Phone/Fax
| Phone: | 7702923490 |
| Fax: | 7707215615 |
Provider Mailing Location
460 NORTHSIDE CHEROKEE BLVD STE 100
CANTON
GA
301158017
Provider Mailing Phone/Fax
| Phone: | 7702923490 |
| Fax: | 7707215615 |