| Doctor Name: | DR. TOPAZ JERILYN HOLLOWAY |
| NPI Number: | 1194151993 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AGPCNP |
| License Number: | 4704257322 |
| Business Practice Address: | 4154 W Vienna Rd Clio, MI - 484202809 |
| Business Phone Number: | 8106871008 |
| Business Fax Number: | |
| Mailing Address: | 4154 W Vienna Rd, CLIO |
| State: | MI |
| Postal Code: | 484202809 |
| Phone Number: | 8106871008 |
| Fax Number: | |
| NPI Enumeration Date: | 09/25/2013 |
| NPI Last Update Date: | 10/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 4704257322 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |