Provider Demographics
NPI:1831703180
Name:MCCORD, HOLLY (FNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:MCCORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8673 ELIZAVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:KY
Mailing Address - Zip Code:41039-8685
Mailing Address - Country:US
Mailing Address - Phone:606-782-0276
Mailing Address - Fax:
Practice Address - Street 1:989 MEDICAL PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8750
Practice Address - Country:US
Practice Address - Phone:606-759-9424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPENDING363L00000X
KY3015048363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner