# HOLLY VANDERGRIFF

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

## Provider details

- **NPI number:** 1760886378
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN323882 | OH | — |
| 363L00000X | Nurse Practitioner | 3011717 | KY | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | COA 16736 NP | OH | — |

## Other

- **Enumeration date:** 10/13/2014
- **Last updated:** 10/29/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0113154 | — | OH |
| 05 | — | 201270520 | — | IN |
| 05 | — | 7100325410 | — | KY |