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General NPI Number Information
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NPI Number | 1932694288
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Entity Type | Individual
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Provider Name | HOLLEY L HILLIS PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 11900 N PENN ST STE 104
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City | CARMEL
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State | IN
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Zip | 46032-4694
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Country | US
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Telephone | 216-468-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 115 W 3RD ST
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City | PERU
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State | IN
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Zip | 46970-2150
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Country | US
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Telephone | 765-464-4626
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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 | 11004074
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License Number State | FL
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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 | 71008110A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71008110A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN-2823
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License Number State | HI
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