Provider Demographics
NPI:1285639013
Name:FROST, HOLLY (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 FRUITVILLE PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4087
Mailing Address - Country:US
Mailing Address - Phone:717-569-6481
Mailing Address - Fax:717-569-5213
Practice Address - Street 1:1570 FRUITVILLE PIKE STE 100
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4087
Practice Address - Country:US
Practice Address - Phone:717-569-6481
Practice Address - Fax:717-569-5213
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033691E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2658530OtherAETNA REF ID
CT010039781CT01OtherBCBS N BCFP PROV ID
CT004195930Medicaid
CT0874481-003OtherCIGNA ID
CT0V0463OtherHEALTH NET ID
CT1255448155OtherGHMC GRP NPI ID
CT060916784-003OtherTRICARE HNFS ID
CT759412OtherCONNECTICARE ID
CTP2543273OtherOXFORD ID
CT001397810Medicaid