Provider Demographics
NPI:1467813311
Name:DUNCAN, HOLLY PRUETT (CPNP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:PRUETT
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2932 BROOKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-9410
Mailing Address - Country:US
Mailing Address - Phone:828-328-1118
Mailing Address - Fax:828-328-1119
Practice Address - Street 1:4355 HICKORY BLVD STE 3
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630
Practice Address - Country:US
Practice Address - Phone:828-757-5040
Practice Address - Fax:828-757-5041
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008445363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics