Provider Demographics
NPI:1740684406
Name:ERNST, HOLLY D (PA-C)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:D
Last Name:ERNST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 PANHANDLE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2486
Mailing Address - Country:US
Mailing Address - Phone:940-503-3601
Mailing Address - Fax:940-503-3602
Practice Address - Street 1:2510 PANDLEHANDLE STREET
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-503-3601
Practice Address - Fax:940-503-3602
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NE1859363AM0700X, 363AS0400X
CA54599363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX781155OtherTMB TEMPORARY LICENSE
MT132464OtherSTATE MEDICAL LICENSE
NE1859OtherSTATE MEDICAL LICENSE