Provider Demographics
NPI:1154833531
Name:HOLLEY, AMY KATHRYN (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:KATHRYN
Last Name:HOLLEY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 LEIGHTON AVE STE 702
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5765
Mailing Address - Country:US
Mailing Address - Phone:256-473-4518
Mailing Address - Fax:
Practice Address - Street 1:901 LEIGHTON AVE STE 702
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5765
Practice Address - Country:US
Practice Address - Phone:256-231-2552
Practice Address - Fax:256-231-2550
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-104921363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care