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NPI Profile for HOLLY WILDS in COLUMBUS, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1326487414 |
|
| Status | Active | |
| Credentials | FNP (Family Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 06/21/2013 | |
| Last updated | 08/16/2018 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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HOLLY WILDS
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HOLLY WILDS, FNP