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General NPI Number Information
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NPI Number | 1265054076
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Entity Type | Individual
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Provider Name | HOLLY RACHELLE TYRPAK BARD DNP, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 08/14/2022
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Provider Practice Location Address
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Address Line | 1703 LAUREL ST
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City | COLUMBIA
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State | SC
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Zip | 29201-2660
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Country | US
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Telephone | 844-330-7799
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Fax |
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Provider Business Mailing Address
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Address Line | 5428 ROXBURY DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29418-2041
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Country | US
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Telephone | 843-343-9132
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 61293119
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 24317
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 228530
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License Number State | SC
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