Provider Demographics
NPI:1659625309
Name:JAMISON, HOLLY ANNE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ANNE
Last Name:JAMISON
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:888-339-6065
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:4740 COMMERCIAL PARK CT
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9387
Practice Address - Country:US
Practice Address - Phone:336-245-9521
Practice Address - Fax:855-308-2340
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005881363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCS2404500328OtherCARESOURCE
NCQ00260028OtherRAILROAD MEDICARE
NC7877454OtherUHC
NC8018003OtherCIGNA
NC1659625309Medicaid
NCLX493E-AEOtherDEVOTED HEALTH
NCNCG841DOtherMEDICARE
NC1865HOtherBCBS NC