Individual
HOLLY E. HERTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1301 KS HWY 264, LARNED, KS 67550-5353
(620) 285-4507
(620) 285-4509
Mailing address
1301 KS HWY 264, LARNED, KS 67550-5353
(620) 285-4507
(620) 285-4509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
45260
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100413870A
—
KS
01
—
160749
BLUE SHIELD
KS
Enumeration date
08/09/2005
Last updated
03/31/2010
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