Individual
HOLLY VANDERGRIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4900 HOUSTON RD, FLORENCE, KY 41042-4824
(859) 331-6466
(859) 344-7930
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 331-6466
(859) 344-7930
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN323882
OH
363L00000X
Nurse Practitioner
Primary
3011717
KY
363LA2100X
Acute Care Nurse Practitioner
COA 16736 NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113154
—
OH
05
—
201270520
—
IN
05
—
7100325410
—
KY
Enumeration date
10/13/2014
Last updated
10/29/2021
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