Healthcare Provider Details

I. General information

NPI: 1255209854
Provider Name (Legal Business Name): HOLLY MAY ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8346 BEARBERRY ST
ANCHORAGE AK
99502-4351
US

IV. Provider business mailing address

8346 BEARBERRY ST
ANCHORAGE AK
99502-4351
US

V. Phone/Fax

Practice location:
  • Phone: 843-812-9061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN83958
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number221468
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: