Provider Demographics
NPI:1629332010
Name:HOLLY, ASHLEY BARTELS (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BARTELS
Last Name:HOLLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2750 CLAY EDWARDS DR STE 312
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3256
Mailing Address - Country:US
Mailing Address - Phone:816-453-4000
Mailing Address - Fax:816-842-1486
Practice Address - Street 1:2750 CLAY EDWARDS DR STE 312
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3256
Practice Address - Country:US
Practice Address - Phone:816-453-4000
Practice Address - Fax:816-842-1486
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017007799208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1629332010Medicaid