Provider Demographics
NPI:1518050426
Name:WYSS, HOLLY P (RN, CS, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:P
Last Name:WYSS
Suffix:
Gender:F
Credentials:RN, CS, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8233 RAILROAD RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-4576
Mailing Address - Country:US
Mailing Address - Phone:317-887-2610
Mailing Address - Fax:317-887-2636
Practice Address - Street 1:8233 RAILROAD RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-4576
Practice Address - Country:US
Practice Address - Phone:317-887-2610
Practice Address - Fax:317-887-2636
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001532A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily