MEDICARE: HOLLY K LETTERMAN-HITT FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2020005222	MO

General Provider Information

NPI Number	:	1265066690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY K LETTERMAN-HITT FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 397
Second Line	:
City	:	NIXA
State	:	MO
Zip	:	65714-0397
Country	:	US
Telephone Number	:	417-210-7003
Fax Number	:	417-210-7006

Provider Business Practice Location Address
First Line	:	105 S RIDGECREST AVE STE 3C
Second Line	:
City	:	NIXA
State	:	MO
Zip	:	65714-6206
Country	:	US
Telephone Number	:	417-210-7003
Fax Number	:	417-210-7006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2020
Last Update Date	:	12/18/2024

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