Provider Demographics
NPI:1639536972
Name:CHITWOOD, HOLLY RENEA (APRN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:RENEA
Last Name:CHITWOOD
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 1:800 ROSE ST WHITNEY HENDRICKSON STE 134
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-2650
Mailing Address - Fax:859-323-0702
Practice Address - Street 1:800 ROSE ST WHITNEY HENDRICKSON STE 134
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0093
Practice Address - Country:US
Practice Address - Phone:859-323-2650
Practice Address - Fax:859-323-0702
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010014363L00000X, 363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily