Individual
MRS. HOLLY ANN GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
203 BAILEY LN STE 1, BENTON, IL 62812-2266
(618) 438-5670
(618) 438-5709
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277001378
IL
363LF0000X
Family Nurse Practitioner
Primary
277.001378
IL
Other
Enumeration date
08/08/2018
Last updated
02/04/2026
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