Provider Demographics
NPI:1508680091
Name:HANG, HOLLY (BSN, RN)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:HANG
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:HANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:122 LAW ST
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3239
Mailing Address - Country:US
Mailing Address - Phone:920-202-0189
Mailing Address - Fax:
Practice Address - Street 1:122 LAW ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-3239
Practice Address - Country:US
Practice Address - Phone:920-202-0189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1116864163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice