Provider Demographics
NPI:1235809229
Name:EDWARDS, HOLLIS (RD)
Entity type:Individual
Prefix:
First Name:HOLLIS
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 E VALERIE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-1640
Mailing Address - Country:US
Mailing Address - Phone:480-652-6159
Mailing Address - Fax:623-505-3474
Practice Address - Street 1:3080 N CIVIC CENTER PLZ STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6921
Practice Address - Country:US
Practice Address - Phone:480-378-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered