Provider Demographics
NPI:1932330214
Name:BOYLES, HOLLI RENEE (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:RENEE
Last Name:BOYLES
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:HOLLI
Other - Middle Name:RENEE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2077 STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-9743
Mailing Address - Country:US
Mailing Address - Phone:417-699-2715
Mailing Address - Fax:
Practice Address - Street 1:2077 STADIUM DR
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-9743
Practice Address - Country:US
Practice Address - Phone:417-699-2715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2023-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-80788-032363L00000X
OK206502363L00000X
MO2022020064363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner