Provider Demographics
NPI:1376160119
Name:CURRY, HOLLY E
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:E
Last Name:CURRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ELIZABETH
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:311 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44902-1511
Mailing Address - Country:US
Mailing Address - Phone:567-203-7414
Mailing Address - Fax:
Practice Address - Street 1:311 E 3RD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44902-1511
Practice Address - Country:US
Practice Address - Phone:567-203-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-27
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX757687363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX757687Medicaid