| Provider / Organization | NPI | Date Certified |
|---|---|---|
| HOLLY SHORT | 1285280313 | 2019-08-14 |
Holly Short [F] graduated in 2019 and primarily specializes in Nurse Practitioner.
Holly Short is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1285280313. Registration indicates Holly Short is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 4183056989 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Holly Short FNP |
| Other Provider Name | Holly Kowanick |
| Practice Office Address | 5838 SIX FORKS RD STE 100 RALEIGH, NC US |
| Practice Office Telephone | 9197853400 |
| Practice Office Fax | 9197837778 |
| Mailing Address | 501 SPRUCE HOLLOW DR FUQUAY VARINA, NC 275268188 US |
| Business Telephone | 9192713123 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 5012132
NC |