Provider Demographics
NPI:1487433074
Name:DOOGS, HOLLY (FNP-C)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:DOOGS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 HIGHWAY D
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3169
Mailing Address - Country:US
Mailing Address - Phone:573-392-5606
Mailing Address - Fax:573-392-5655
Practice Address - Street 1:931 HIGHWAY D
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3169
Practice Address - Country:US
Practice Address - Phone:573-392-5606
Practice Address - Fax:573-392-5655
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023032195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily