| Hollen Family Medicine, Pllc | |
|
1525 E Beltline Ave Ne Ste 102 Grand Rapids MI 49525-4598 | |
| (616) 363-0055 | |
| (616) 363-5180 |
| Full Name | Hollen Family Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1525 E Beltline Ave Ne Ste 102, Grand Rapids, Michigan |
| Authorized Official Name and Position | Brittanny Snow (PRACTICE MANAGER) |
| Authorized Official Contact | 6163630055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hollen Family Medicine, Pllc 1525 E Beltline Ave Ne Ste 102 Grand Rapids MI 49525-4598 Ph: (616) 363-0055 | Hollen Family Medicine, Pllc 1525 E Beltline Ave Ne Ste 102 Grand Rapids MI 49525-4598 Ph: (616) 363-0055 |
| NPI Number | 1063977528 |
|---|---|
| Provider Enumeration Date | 02/08/2019 |
| Last Update Date | 06/12/2020 |
| Medicare PECOS PAC ID | 9133469810 |
|---|---|
| Medicare Enrollment ID | O20190315000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063977528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dana L Marino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295982536 PECOS PAC ID: 3173512662 Enrollment ID: I20040510001089 |
| Provider Name | Amy Hollen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750463816 PECOS PAC ID: 0345374773 Enrollment ID: I20100819001147 |
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