Healthcare Provider Details

I. General information

NPI: 1164579116
Provider Name (Legal Business Name): HOLLY HARDIGREE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 E VAUGHN AVE
RUSTON LA
71270-5972
US

IV. Provider business mailing address

3207 LEYLAND DR
RUSTON LA
71270-2023
US

V. Phone/Fax

Practice location:
  • Phone: 318-254-2589
  • Fax: 318-255-3343
Mailing address:
  • Phone: 318-254-2589
  • Fax: 318-255-3343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP04555
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP04555
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: