Provider Demographics
NPI:1598326233
Name:SHOURD, HOLLY BROOKE (FNP)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:BROOKE
Last Name:SHOURD
Suffix:
Gender:
Credentials:FNP
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:BROOKE
Other - Last Name:HENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 HUGHES DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1505
Mailing Address - Country:US
Mailing Address - Phone:731-668-2800
Mailing Address - Fax:731-668-6161
Practice Address - Street 1:31 HUGHES DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1505
Practice Address - Country:US
Practice Address - Phone:731-668-2800
Practice Address - Fax:731-668-6161
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily