Provider Demographics
NPI:1487610317
Name:COVINGTON, HOLLY (RN, PHD, PMHNP, FNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:RN, PHD, PMHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 HOOKANO ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-6216
Mailing Address - Country:US
Mailing Address - Phone:970-413-3776
Mailing Address - Fax:833-536-1752
Practice Address - Street 1:2232 N 7TH ST STE 7
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7454
Practice Address - Country:US
Practice Address - Phone:970-413-3776
Practice Address - Fax:833-536-1752
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4296363LP0808X, 363LF0000X, 363LP0808X
CO2115364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist