MEDICARE: HOLLY ANN KLEYPAS MSN, 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	363L00000X	Nurse Practitioner	AP140581	TX

General Provider Information

NPI Number	:	1609333095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY ANN KLEYPAS MSN, FNP-BC

Provider Business Mailing Address
First Line	:	4153 VINTAGE HILLS DR
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77808-7585
Country	:	US
Telephone Number	:	979-777-1806
Fax Number	:

Provider Business Practice Location Address
First Line	:	1121 BRIARCREST DR STE 303
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-2500
Country	:	US
Telephone Number	:	979-774-1500
Fax Number	:

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

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	05/05/2021

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