Provider Demographics
NPI:1578296711
Name:MURCH, HOLLY ANNE (APRN)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:ANNE
Last Name:MURCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 OAKMONT CIR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3709
Mailing Address - Country:US
Mailing Address - Phone:407-222-3633
Mailing Address - Fax:
Practice Address - Street 1:5440 S WILLIAMSON BLVD UNIT 104
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-7422
Practice Address - Country:US
Practice Address - Phone:386-425-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily