Provider Demographics
NPI:1164834651
Name:MORNING-FANNIN, HOLLY ANNE (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ANNE
Last Name:MORNING-FANNIN
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 HAL GREER BLVD
Mailing Address - Street 2:ATTN: TAMMIE SILVA
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3800
Mailing Address - Country:US
Mailing Address - Phone:304-526-2000
Mailing Address - Fax:
Practice Address - Street 1:4 CHATEAU GROVE LANG
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504
Practice Address - Country:US
Practice Address - Phone:304-736-4000
Practice Address - Fax:304-736-4751
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15773-NP363L00000X
WV70774363L00000X
WVAPRN70774363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0106232OtherMEDICAID
OH0106232Medicaid
WV1164834651Medicaid
KY7100306410Medicaid