Provider Demographics
NPI:1265054076
Name:BARD, HOLLY RACHELLE TYRPAK (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:RACHELLE TYRPAK
Last Name:BARD
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5428 ROXBURY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-2041
Mailing Address - Country:US
Mailing Address - Phone:843-343-9132
Mailing Address - Fax:
Practice Address - Street 1:1703 LAUREL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2660
Practice Address - Country:US
Practice Address - Phone:844-330-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC228530163W00000X
WA61293119363LP0808X
SC24317363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse