Provider Demographics
NPI:1609107390
Name:GARNER, HOLLY R (MSN, FNP, FN-C)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:R
Last Name:GARNER
Suffix:
Gender:F
Credentials:MSN, FNP, FN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37938
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28237-7938
Mailing Address - Country:US
Mailing Address - Phone:704-332-0396
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:3158 FREEDOM DR STE 3101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-0014
Practice Address - Country:US
Practice Address - Phone:704-348-2992
Practice Address - Fax:704-334-3061
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2594665Medicare PIN