Provider Demographics
NPI:1689229437
Name:BARRETT, HOLLY KAY (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:KAY
Last Name:BARRETT
Suffix:
Gender:F
Credentials:APRN, CNP
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 144
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:WI
Mailing Address - Zip Code:54822-0144
Mailing Address - Country:US
Mailing Address - Phone:715-458-3124
Mailing Address - Fax:715-458-3125
Practice Address - Street 1:W7164 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:SPOONER
Practice Address - State:WI
Practice Address - Zip Code:54801-6605
Practice Address - Country:US
Practice Address - Phone:715-939-1294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9459-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily