Provider Demographics
NPI:1740710409
Name:KING, HOLLY LYNNE (CMSRN BSN MSN)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:LYNNE
Last Name:KING
Suffix:
Gender:F
Credentials:CMSRN BSN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1703
Mailing Address - Country:US
Mailing Address - Phone:412-818-8080
Mailing Address - Fax:
Practice Address - Street 1:1517 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1703
Practice Address - Country:US
Practice Address - Phone:412-818-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA549575163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical