Individual
HOLLY K WILLYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
605 WEST TAYLOR, LOVINGTON, NM 88260
(575) 739-0062
(575) 396-1454
Mailing address
1600 NORTH MAIN, LOVINGTON, NM 88260-2830
(575) 396-6611
(575) 396-1454
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP00494
NM
363LF0000X
Family Nurse Practitioner
R26153
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515063YNGG
PTAN
NM
05
—
99177528
—
NM
Enumeration date
03/13/2007
Last updated
08/17/2017
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