Provider Demographics
NPI:1346502978
Name:MUSGROVE, HOLLY BROSIUS (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:BROSIUS
Last Name:MUSGROVE
Suffix:
Gender:F
Credentials:CPNP
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR # 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-5412
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:10807 FALLS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-321-9393
Practice Address - Fax:410-825-4945
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2018-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR106999363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner