Provider Demographics
NPI:1336823533
Name:WINN, HOLLY (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:WINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UND SMHS DEPARTMENT OF SURGERY
Mailing Address - Street 2:1301 N COLUMBIA RD, STOP 9037
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58202
Mailing Address - Country:US
Mailing Address - Phone:701-777-3069
Mailing Address - Fax:
Practice Address - Street 1:UND SMHS DEPARTMENT OF SURGERY
Practice Address - Street 2:1301 N COLUMBIA RD, STOP 9037
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202
Practice Address - Country:US
Practice Address - Phone:701-777-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NDRL19763208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery