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General NPI Number Information
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NPI Number | 1285280313
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Entity Type | Individual
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Provider Name | HOLLY MARIE SHORT FNP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 2400 N MAIN ST
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-8573
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Country | US
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Telephone | 919-235-6499
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 602195
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City | CHARLOTTE
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State | NC
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Zip | 28260-2195
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Country | US
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Telephone | 919-350-0351
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Fax | 919-350-7687
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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 | 5012132
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5012132
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License Number State | NC
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