Provider Demographics
NPI:1700865151
Name:KIRKLAND-KYHN, HOLLY JEAN
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:JEAN
Last Name:KIRKLAND-KYHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:JEAN
Other - Last Name:KIRKLAND-KYHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:3644 VOLEYN ST
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2863
Mailing Address - Country:US
Mailing Address - Phone:916-508-1963
Mailing Address - Fax:916-973-5820
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:DAVIS 6
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-703-7143
Practice Address - Fax:916-703-7144
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7715363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner