Provider Demographics
NPI:1891493656
Name:MCKINNEY, HOLLY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W MITCHELL ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2276
Mailing Address - Country:US
Mailing Address - Phone:231-487-2340
Mailing Address - Fax:231-487-2115
Practice Address - Street 1:560 W MITCHELL ST STE 210
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2276
Practice Address - Country:US
Practice Address - Phone:231-487-2340
Practice Address - Fax:231-487-2115
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704299319363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner