National Provider Identifier

Nicelee Fall Hollenback, NPP

Nicelee Fall Hollenback, NPP is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Ithaca, NY and a listed phone number of (607) 342-5728.

NPI 1801172614Ithaca, NYPsychiatric/Mental Health Nurse Practitioner

Profile Overview

NPI
1801172614
Provider Type
Individual
Primary Specialty
Psychiatric/Mental Health Nurse Practitioner
Enumeration Date
October 25, 2011
Last Updated
September 21, 2023

Practice Location

  • 950 Danby RD Ste 202A
  • Ithaca, NY 14850-5714

Phone: (607) 342-5728

Mailing Address

  • 28 Goodband RD
  • Freeville, NY 13068-9651

Specialties

  • Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
Full Record
NPI
1801172614
Entity Type
Individual
Last Name
Hollenback
First Name
Nicelee
Middle Name
Fall
Credential
NPP
Mailing Street Address
28 Goodband RD
Mailing City
Freeville
Mailing State
NY
Mailing ZIP Code
13068-9651
Mailing Country
US
Mailing Phone
(607) 342-5728
Mailing Fax
(607) 238-4687
Practice Street Address
950 Danby RD Ste 202A
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-5714
Practice Country
US
Practice Phone
(607) 342-5728
Practice Fax
(607) 238-4687
Enumeration Date
October 25, 2011
Last Updated
September 21, 2023
Sex
Female
Sole Proprietor
Yes
Certification Date
September 21, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
Other Identifiers
401500 (NY, Npp), 5344741 (NY, Ny State Rnp License)