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General NPI Number Information
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NPI Number | 1144872110
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Entity Type | Individual
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Provider Name | HOLLY CIARA MINGUS NOE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 5800 OVERSEAS HWY STE 38
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City | MARATHON
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State | FL
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Zip | 33050-2744
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Country | US
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Telephone | 305-743-7111
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Fax | 305-743-7709
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Provider Business Mailing Address
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Address Line | 2262 ORLANDO RD
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City | BIG PINE KEY
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State | FL
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Zip | 33043-6318
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 218423
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9326707
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11003254
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License Number State | FL
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