=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376403162
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOLLY ELAINE FLIPPIN MSN, APRN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2025
-----------------------------------------------------
Last Update Date | 11/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 324 T B STANLEY HWY
-----------------------------------------------------
City | BASSETT
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24055-6108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-638-0787
-----------------------------------------------------
Fax | 276-629-2695
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 324 T B STANLEY HWY
-----------------------------------------------------
City | BASSETT
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24055-6108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-638-0787
-----------------------------------------------------
Fax | 276-629-2695
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 0024195362
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------