Provider Demographics
NPI:1982212106
Name:WEST, HOLLY ANNE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ANNE
Last Name:WEST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ALYSSA DR
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01469-1435
Mailing Address - Country:US
Mailing Address - Phone:978-828-1249
Mailing Address - Fax:
Practice Address - Street 1:23 ALYSSA DR
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MA
Practice Address - Zip Code:01469-1435
Practice Address - Country:US
Practice Address - Phone:978-828-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2286550363LF0000X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory