Healthcare Provider Details

I. General information

NPI: 1235468679
Provider Name (Legal Business Name): HOLLY BREWER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6860 W 115TH ST
OVERLAND PARK KS
66211-2400
US

IV. Provider business mailing address

16457 S PENROSE LN
OLATHE KS
66062-8155
US

V. Phone/Fax

Practice location:
  • Phone: 877-620-6194
  • Fax:
Mailing address:
  • Phone: 281-974-0654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115354
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number75770
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: