| Doctor Name: | MS. MARY PAT HOLLER-BIBEL |
| NPI Number: | 1023075975 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | R26553 |
| Business Practice Address: | 3593 Medina Rd Ste 181 Medina, OH - 442568182 |
| Business Phone Number: | 3305363746 |
| Business Fax Number: | 8882045174 |
| Mailing Address: | 3593 Medina Rd Ste 181, MEDINA |
| State: | OH |
| Postal Code: | 442568182 |
| Phone Number: | 3305363746 |
| Fax Number: | 8882045174 |
| NPI Enumeration Date: | 04/26/2006 |
| NPI Last Update Date: | 03/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R26553 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |