Provider Demographics
NPI:1316958408
Name:JEFFREYS, HOLLY L (FNP-C)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:L
Last Name:JEFFREYS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:PANHANDLE
Mailing Address - State:TX
Mailing Address - Zip Code:79068-0010
Mailing Address - Country:US
Mailing Address - Phone:806-532-2273
Mailing Address - Fax:806-532-2276
Practice Address - Street 1:102 HWY 60 E
Practice Address - Street 2:
Practice Address - City:PANHANDLE
Practice Address - State:TX
Practice Address - Zip Code:79068
Practice Address - Country:US
Practice Address - Phone:806-532-2273
Practice Address - Fax:806-532-2276
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX648580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y3245OtherBCBS
TX092485403Medicaid
TX133340100OtherSOUTHWEST LIFE & HEALTH
TX133340100OtherFIRST CARE
TX160981001Medicaid
TX8N4852OtherBCBS
TXP81879Medicare UPIN
TX8K2324Medicare PIN
TX133340100OtherFIRST CARE
TX8N4852OtherBCBS