Provider Demographics
NPI:1548660798
Name:HOLLAND, KELLI (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:KELLI
Other - Middle Name:
Other - Last Name:GALBRAITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 9170
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50306-9170
Mailing Address - Country:US
Mailing Address - Phone:515-633-3600
Mailing Address - Fax:515-633-3838
Practice Address - Street 1:1816 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8771
Practice Address - Country:US
Practice Address - Phone:515-232-2500
Practice Address - Fax:515-246-4479
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA117102363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner