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General NPI Number Information
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NPI Number | 1154328581
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Entity Type | Individual
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Provider Name | HOLLY GROSS FNP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 101 MANNING DR
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City | CHAPEL HILL
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State | NC
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Zip | 27514-4220
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Country | US
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Telephone | 919-966-3745
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Fax |
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Provider Business Mailing Address
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Address Line | 11510 AULDBURY WAY
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City | RALEIGH
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State | NC
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Zip | 27617-7848
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Country | US
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Telephone | 919-671-2266
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201213
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License Number State | NC
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