Healthcare Provider Details

I. General information

NPI: 1740064401
Provider Name (Legal Business Name): HOLLY JOY LOVING FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3436 W BELL RD
PHOENIX AZ
85053-2926
US

IV. Provider business mailing address

30825 N NORTH VALLEY PKWY UNIT 1018
PHOENIX AZ
85085-0277
US

V. Phone/Fax

Practice location:
  • Phone: 480-677-8282
  • Fax: 888-316-1686
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number14371-33
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number326352
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: