| NPI | 1366843674 | 
|---|---|
| Former Name | HOLLY RENEE WILLIAMS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1955)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4424)  | 
| 363AM0700X Physician Assistant, Medical (Licence: KY PA1955)  | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA1955)  | |
| Enumeration Date | 2014-09-06 | 
| Last Update Date | 2024-09-13 |