# DR. HOLLY C PROVOST

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356349245
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 024378 | LA | Yes |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 07/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1571831 | — | LA |
| 01 | — | 160059334 | RAILROAD MEDICARE PROV \# | LA |
| 01 | — | 7352418 | AETNA PROVIDER ID NUMBER | AL |