Provider Demographics
NPI:1417253519
Name:HOLLIGAN, RICHARD (RN)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HOLLIGAN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SYMPHONY AVE
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1955
Mailing Address - Country:US
Mailing Address - Phone:702-338-8772
Mailing Address - Fax:
Practice Address - Street 1:6 SYMPHONY AVE
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1955
Practice Address - Country:US
Practice Address - Phone:702-338-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN50008163WC0400X
NJ26NJ15088000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management