MRS. HOLLY J CLUCK (NPI# 1275875585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275875585 |
| Entity Type | Individual |
| Full Name | MRS. HOLLY J CLUCK |
| Credential | CRNP |
| Practice Address |
2065 E South Blvd Suite 201 Montgomery AL 36116-2458 |
| Mailing Address |
301 Brown Springs Rd Attn: Provider Enrollment Montgomery AL 36117-7005 |
| Practice Telephone | 3347477250 |
| Practice Fax Number | 3347477270 |
| Mailing Telephone | 3342734159 |
| Mailing Fax Number | 3342734290 |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2017-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
1-106380 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366712952 | Holly J Cluck | Physical Therapy Assistant | 1465 Oakfield Dr, Brandon, FL 33511-4854 | 2012-01-12 |
| Street Address |
2065 E SOUTH BLVD SUITE 201 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36116-2458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275574030 | Carri Carpenter | Physical Therapist | 2065 E South Blvd, Ste. 101, Montgomery, AL 36116-2458 | 2006-06-10 |
| 1194275321 | Ashley Powell | Nurse Practitioner | 2065 E South Blvd, Suite 204, Montgomery, AL 36116-2458 | 2016-10-12 |
| 1467793224 | Jessica Adair | Nurse Practitioner | 2065 E South Blvd, Montgomery, AL 36116-2458 | 2013-03-04 |
| 1952649261 | Hca for Baptist Health, An Affiliate of Uab Health System | Health Educator | 2065 E South Blvd, Parker Pavilion, Suite 404, Montgomery, AL 36116-2458 | 2013-01-21 |
| 1487926259 | Caitlin E Butts | Physical Therapist | 2065 E South Blvd, Ste 101, Montgomery, AL 36116-2458 | 2012-02-08 |
| 1558501460 | Richard H Chin | Psychiatry & Neurology | 2065 E South Blvd, Suite 201, Montgomery, AL 36116-2458 | 2009-03-05 |
| 1528215811 | Ashish Atulbhai Vyas | Psychiatry & Neurology | 2065 E South Blvd, Suite 201, Montgomery, AL 36116-2458 | 2008-08-19 |
| 1205982998 | David Phillp Herrick | Pain Medicine | 2065 E South Blvd, 401, Montgomery, AL 36116-2458 | 2007-01-26 |
| 1184726580 | Amy D Rapp | Physician Assistant | 2065 E South Blvd, Suite 204, Montgomery, AL 36116-2458 | 2006-09-05 |
| 1801998844 | Robert H. Bradley | Neurological Surgery | 2065 E South Blvd, Suite 204, Montgomery, AL 36116-2463 | 2006-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275153892 | Sayyeda Ann Uz Zahra | Student in an Organized Health Care Education/Training Program | 2055 East South Blvd. Suite 202, Uab Montgomery, Montgomery, AL 36116 | 2020-04-23 |
| 1861958241 | Tameka Lene' Myles | Nurse Practitioner | 2905 East South Boulevard, Montgomery, AL 36116 | 2019-02-11 |
| 1750869814 | Nina Yvette Massey | Family Medicine | Baptist South Uab Multi Specialty Clinic, 2119 E. South Blvd, Montgomery, AL 36116 | 2018-08-01 |
| 1336635697 | Briana Lynn Adair | Speech-Language Pathologist | 2185 Normandie Rd., Montgomery, AL 36116 | 2018-07-10 |
| 1790201770 | Rinka Ravi Pahwani | Student in an Organized Health Care Education/Training Program | 4371 Narrow Lane Road, Suite 100, Montgomery, AL 36116 | 2017-08-21 |
| 1982052015 | Kevin J Jones | Pharmacist | 4385 Narrow Lane Rd, Montgomery, AL 36116 | 2016-05-31 |
| 1891153284 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 8035 Vaughn Road, Montgomery, AL 36116 | 2016-02-01 |
| 1871917583 | E Dental | Dentist | 6956 Vaughn Rd, Montgomery, AL 36116 | 2014-02-17 |
| 1033545199 | Jennings Professional Services LLC | Home Health | 2921 Martin Lane, Montgomery, AL 36116 | 2013-09-20 |
| 1750721973 | Joseph Alan Taylor | Counselor | 8104 Seaton Place, Montgomery, AL 36116 | 2013-07-02 |
| Find all providers in zip 36116 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063735413 | Advance Health Providers LLC | Nurse Practitioner | 2460 Hanbury Ln, Montgomery, IL 60538-5049 | 2010-03-12 |
| 1194322271 | Ryan Shannon | Nurse Practitioner | 1722 Pine St Ste 700, Montgomery, AL 36106-1125 | 2020-10-02 |
| 1053805473 | Jolisa Watson | Nurse Practitioner | 1845 Cherry St, Montgomery, AL 36107-2613 | 2018-06-19 |
| 1265976005 | Tracey England | Nurse Practitioner | 2100 Chestnut St, Montgomery, AL 36106-1113 | 2016-12-13 |
| 1841733045 | Angela Floyd | Nurse Practitioner | 1725 Pine St, Montgomery, AL 36106-1109 | 2016-11-21 |
| 1053867945 | Jessica Rollins | Nurse Practitioner | 1845 Cherry St, Montgomery, AL 36107-2613 | 2016-08-30 |
| 1063897635 | Shawona Cannon Daniel | Nurse Practitioner | 2034 Chestnut St, Montgomery, AL 36106-1111 | 2015-07-24 |
| 1861876252 | The Center for Pain of Montgomery PC | Nurse Practitioner | 2065 E South Blvd Ste 401, Montgomery, AL 36116-2462 | 2015-07-15 |
| 1033532874 | Holly Yates Vezertzis | Nurse Practitioner | 2055 E South Blvd, Suite 308, Montgomery, AL 36116-2001 | 2014-01-30 |
| 1861827669 | Lilian Ifeoma Akwuba | Nurse Practitioner | 128 Mitylene Park Ln, Montgomery, AL 36117-3758 | 2013-09-11 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36116 |
Please comment or provide details below to improve the information on MRS. HOLLY J CLUCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.