Healthcare Provider Details

I. General information

NPI: 1669058483
Provider Name (Legal Business Name): HOLLY ZIRNHELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 05/06/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ABRAHAM FLEXNER WAY STE 1001
LOUISVILLE KY
40202-3841
US

IV. Provider business mailing address

PO BOX 909
LOUISVILLE KY
40201-0909
US

V. Phone/Fax

Practice location:
  • Phone: 502-587-2883
  • Fax:
Mailing address:
  • Phone: 502-587-2883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3015834
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: