| NPI | 1063025179 |
|---|---|
| Former Name | HOLLY BLACKWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 217303) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 298191) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5013526) | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2025-01-16 |