Provider Demographics
NPI:1629310131
Name:ANSLEY, HOLLY LEANN (RN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LEANN
Last Name:ANSLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S CEDAR CIR
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-2052
Mailing Address - Country:US
Mailing Address - Phone:417-782-2917
Mailing Address - Fax:
Practice Address - Street 1:214 W 5TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-2598
Practice Address - Country:US
Practice Address - Phone:417-782-2917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007007899163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health