Individual ProviderHolly HonderdPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address275 Michigan St NE, Grand Rapids, MI 49503-2531(616) 267-8700PECOS EnrollmentBased on the most recent information from CMS, provider Holly Honderd is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1376171991Provider TypeIndividualFull NameHonderd, HollyGenderFemaleSole ProprietorNoEnumeration Date3/30/2020Last Updated1/27/2025Contact InformationPractice LocationPractice Address275 Michigan St NE, Grand Rapids, MI 49503-2531Phone(616) 267-8700Fax(616) 267-8247Mailing LocationMailing Address100 Michigan St NE # Mc845, Grand Rapids, MI 49503-2560PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense5601010019Michigan