RYAN HOLLEY - MALLO DNP FNP-C NPI 1992094403

NPI Information

  • NPI: 1992094403
  • Provider Name: RYAN HOLLEY - MALLO, DNP, FNP-C
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 41800 W 11 MILE RD STE 109
    NOVI, MI
    ZIP 48375
  • Phone: (248) 660-1220

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NPI Details

Ryan Holley - Mallo, DNP, FNP-C is a primary care nurse practitioner in Novi, MI with 14 years of experience. Ryan Holley - Mallo, DNP, FNP-C NPI is 1992094403. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

41800 W 11 MILE RD STE 109
NOVI, MI
ZIP 48375-818
Phone: (248) 660-1220

The NPI 1992094403 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/5/2011 and was last updated on 3/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily4704259565MICHIGANNo
2363LP2300XNurse PractitionerPrimary Care4704259565MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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