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Individual

MS. HOLLY DEMAREST KOCKLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP-BC

Contact information

Practice address
1141 N. ROAD ST., STE K, CAROLINA COASTAL PLASTIC SURGERY, ELIZABETH CITY, NC 27909
(252) 335-2293
(252) 331-2387
Mailing address
1141 N. ROAD ST., STE K, CAROLINA COASTAL PLASTIC SURGERY, ELIZABETH CITY, NC 27909
(252) 335-2293
(252) 331-2387

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
082463
NC
363LF0000X
Family Nurse Practitioner
Primary
200736
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
082463
RN LICENSE NUMBER
NC
01
200736
NCBOM NP PRACTICE NUMBER
NC
05
ZF0000131
NC
Enumeration date
09/29/2006
Last updated
04/22/2016
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