MEDICARE: RICHARD HOLLIGAN PMHNP

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	163WC0400X	Case Management Registered Nurse	RN50008	NV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15088000	NJ

General Provider Information

NPI Number	:	1417253519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD HOLLIGAN PMHNP

Provider Business Mailing Address
First Line	:	160 ATLANTIC CITY BLVD
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-1229
Country	:	US
Telephone Number	:	732-349-5550
Fax Number	:	732-349-0841

Provider Business Practice Location Address
First Line	:	160 ATLANTIC CITY BLVD
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-1229
Country	:	US
Telephone Number	:	732-349-5550
Fax Number	:	732-349-0841

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

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	06/05/2026

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