Provider Demographics
NPI:1992847362
Name:DEAN, HOLLY LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LYNN
Last Name:DEAN
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 1:3700 SUNSET LN
Mailing Address - Street 2:SUITE #7
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6199
Mailing Address - Country:US
Mailing Address - Phone:925-755-7300
Mailing Address - Fax:
Practice Address - Street 1:3700 SUNSET LN
Practice Address - Street 2:SUITE #7
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6199
Practice Address - Country:US
Practice Address - Phone:925-755-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA631791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily