Provider Demographics
NPI:1366948663
Name:AHLERS, HOLLY (CNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:AHLERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:STURZENBECHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:2000 S SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2727
Mailing Address - Country:US
Mailing Address - Phone:605-271-2325
Mailing Address - Fax:605-271-2491
Practice Address - Street 1:2000 S. SUMMIT AVE
Practice Address - Street 2:SIOUX FALLS, SD 57105
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-271-2325
Practice Address - Fax:605-271-2491
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR034644163WP0808X
SDCP001610363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD$$$$$$$$$OtherCLINIC