MEDICARE: HOLLY NICOLE HINSBERGER FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704272207	MI

General Provider Information

NPI Number	:	1831638790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY NICOLE HINSBERGER FNP-C

Provider Business Mailing Address
First Line	:	1177 S LAPEER RD
Second Line	:
City	:	LAPEER
State	:	MI
Zip	:	48446-3081
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1177 S LAPEER RD
Second Line	:
City	:	LAPEER
State	:	MI
Zip	:	48446-3081
Country	:	US
Telephone Number	:	810-245-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2017
Last Update Date	:	05/18/2023

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