Provider Demographics
NPI:1003352626
Name:GRIFFIN, HOLLY MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARIE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:243 AYER PKWY E
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-8999
Mailing Address - Country:US
Mailing Address - Phone:270-584-9050
Mailing Address - Fax:270-584-9046
Practice Address - Street 1:243 EAST AYER PARKWAY
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1282
Practice Address - Country:US
Practice Address - Phone:270-584-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-07
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010934363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine