Provider Demographics
NPI:1033532874
Name:VEZERTZIS, HOLLY YATES (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:YATES
Last Name:VEZERTZIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-273-4508
Mailing Address - Fax:334-273-4290
Practice Address - Street 1:2055 E SOUTH BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2001
Practice Address - Country:US
Practice Address - Phone:334-286-2390
Practice Address - Fax:334-286-2397
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111542363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health