Provider Demographics
NPI:1306334909
Name:KALISH, HOLLY (APN, NP-C)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:KALISH
Suffix:
Gender:F
Credentials:APN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 YORKLYN RD STE 400
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8740
Mailing Address - Country:US
Mailing Address - Phone:302-235-2351
Mailing Address - Fax:
Practice Address - Street 1:722 YORKLYN RD STE 400
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8740
Practice Address - Country:US
Practice Address - Phone:302-235-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-29
Last Update Date:2018-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELB-0000175363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health