Individual
JESSICA CALISTA HOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1331 W 32ND ST, JOPLIN, MO 64804-1601
(417) 347-6737
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-3474
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2023020564
MO
Other
Enumeration date
06/12/2022
Last updated
07/17/2023
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