Provider Demographics
NPI:1689234635
Name:CUEVAS, HOLLY WILLIAMS (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:WILLIAMS
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11775 HONEY BEAR LN
Mailing Address - Street 2:
Mailing Address - City:SAUCIER
Mailing Address - State:MS
Mailing Address - Zip Code:39574-5007
Mailing Address - Country:US
Mailing Address - Phone:601-408-5987
Mailing Address - Fax:
Practice Address - Street 1:4333 15TH ST STE A
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2525
Practice Address - Country:US
Practice Address - Phone:228-863-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily