Basic Information
| Provider Information | |||||||||
| NPI: | 1336530567 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURNS | ||||||||
| FirstName: | HOLLY | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2594 TRAILRIDGE DR E | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800263186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034497740 | ||||||||
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| Practice Location | |||||||||
| Address1: | 209 MAIN STREET | ||||||||
| Address2: | UNIT B | ||||||||
| City: | MEAD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033290870 | ||||||||
| FaxNumber: | 3033940871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2015 | ||||||||
| LastUpdateDate: | 02/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APN.0991452-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.