Provider Demographics
NPI:1275942765
Name:LORING, HOLLY
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:LORING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 AUTUMN LEAF LN
Mailing Address - Street 2:APT 278
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-8647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5115 AUTUMN LEAF LN
Practice Address - Street 2:APT 278
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-8647
Practice Address - Country:US
Practice Address - Phone:608-369-1909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI190256163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse