Healthcare Provider Details
I. General information
NPI: 1427034909
Provider Name (Legal Business Name): HOLLY L KORICA WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/16/2005
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1537 S HIGLEY RD
GILBERT AZ
85296-4771
US
IV. Provider business mailing address
2702 NORTH 3RD STREET SUITE 4020
PHOENIX AZ
85004-4608
US
V. Phone/Fax
- Phone: 489-257-2700
- Fax: 480-257-2701
- Phone: 602-323-3344
- Fax: 602-323-3496
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | RN075083 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | AP7040 |
| License Number State | AR |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | AP0241 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: