Provider Demographics
NPI:1144244856
Name:KIRK, HOLLY V (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:V
Last Name:KIRK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:VEIGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 291826
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-1826
Mailing Address - Country:US
Mailing Address - Phone:830-792-1132
Mailing Address - Fax:830-792-7747
Practice Address - Street 1:703 HILL COUNTRY DR
Practice Address - Street 2:STE 302
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6159
Practice Address - Country:US
Practice Address - Phone:830-792-1132
Practice Address - Fax:830-792-7747
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX583170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L18820Medicare PIN