Provider Demographics
NPI:1477108769
Name:BARTLEY, HOLLY KATHLEEN (APRN)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:KATHLEEN
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3065
Mailing Address - Country:US
Mailing Address - Phone:863-680-7000
Mailing Address - Fax:866-264-8519
Practice Address - Street 1:924 CYPRESS VILLAGE BLVD STE A
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33573-6829
Practice Address - Country:US
Practice Address - Phone:813-633-6121
Practice Address - Fax:866-264-8519
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003134363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily