Provider Demographics
NPI:1255062121
Name:BURNS, HOLLY M (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:M
Last Name:BURNS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:M
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26537 COUNTY ROAD 267
Mailing Address - Street 2:
Mailing Address - City:PUXICO
Mailing Address - State:MO
Mailing Address - Zip Code:63960-8160
Mailing Address - Country:US
Mailing Address - Phone:573-421-6747
Mailing Address - Fax:
Practice Address - Street 1:220 EAST BROAD STREET
Practice Address - Street 2:
Practice Address - City:NAYLOR
Practice Address - State:MO
Practice Address - Zip Code:63953
Practice Address - Country:US
Practice Address - Phone:573-399-2311
Practice Address - Fax:573-399-2646
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021047297363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily