| Provider / Organization | NPI | Date Certified |
|---|---|---|
| HOLLY REBECCA HARRISON | 1710638218 | 2022-03-01 |
Holly Rebecca Harrison is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1710638218. Registration indicates Holly Rebecca Harrison is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Holly Rebecca Harrison PA-C |
| Other Provider Name | Holly Rebecca Reese |
| Practice Office Address | 405 E NIFONG BLVD COLUMBIA, MO US |
| Practice Office Telephone | 5738840146 |
| Practice Office Fax | 5738841066 |
| Mailing Address | PO BOX 843966 KANSAS CITY, MO 641843966 US |
| Business Telephone | 5738843300 |
| Business Fax | 5738840943 |
| Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals. [Direct] | [email protected] | Direct Curators of the University of Missouri |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 1172455
MO |
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 2022003496
MO |
| 220108653 | MEDICAID | MO |