Provider Demographics
NPI:1588262570
Name:CARLSTRAND, HOLLY JOYCE (NP)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:JOYCE
Last Name:CARLSTRAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CARMEL CHASE CT
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3452
Mailing Address - Country:US
Mailing Address - Phone:281-740-4973
Mailing Address - Fax:
Practice Address - Street 1:18 CARMEL CHASE CT
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3452
Practice Address - Country:US
Practice Address - Phone:281-740-4973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016664363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology