1659756229 NPI number — HOLLY N WILLEY APRN-FNP/BC

Table of content: HOLLY N WILLEY APRN-FNP/BC (NPI 1659756229)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659756229 NPI number — HOLLY N WILLEY APRN-FNP/BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLEY
Provider First Name:
HOLLY
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN-FNP/BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WARREN WILLEY
Provider Other First Name:
H
Provider Other Middle Name:
NOEL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN-FNP/BC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1659756229
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34434 KING STREET ROW SUITE 2
Provider Second Line Business Mailing Address:
DELAWARE NEUROLOGY ASSOCIATES
Provider Business Mailing Address City Name:
LEWES
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19958-4787
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-644-8880
Provider Business Mailing Address Fax Number:
302-644-8882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34434 KING STREET ROW SUITE 2
Provider Second Line Business Practice Location Address:
DELAWARE NEUROLOGY ASSOCIATES
Provider Business Practice Location Address City Name:
LEWES
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19958-4787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-644-8880
Provider Business Practice Location Address Fax Number:
302-644-8882
Provider Enumeration Date:
07/24/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  LG0000868 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)