Healthcare Provider Details

I. General information

NPI: 1568382133
Provider Name (Legal Business Name): HOLLY MARIE BARLOW
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 MAIN ST
BAYBORO NC
28515-9632
US

IV. Provider business mailing address

606 MAIN ST
BAYBORO NC
28515-9632
US

V. Phone/Fax

Practice location:
  • Phone: 252-745-3191
  • Fax: 252-745-7385
Mailing address:
  • Phone: 252-745-3191
  • Fax: 252-745-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024944
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: