Holly Anne Light, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704187460 Issued in MI

Practice address

1400 S Sheldon Rd
Plymouth, MI 48170-2140

Phone

(734) 453-5807

NPI assigned

Dec 24, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Woodward Detroit CVS, L.L.C.

  • Pharmacy
  • Plymouth, MI
  • NPI 1134221476
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1033706015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21110 WOODLAND GLEN DR APT 202",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481672445",
            "telephone_number": "734-751-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S SHELDON RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702140",
            "telephone_number": "734-453-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "HOLLY",
        "middle_name": "ANNE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-24",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704187460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "4704187460",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lightholly@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21110 Woodland Glen Dr Apt 202",
            "city": "Northville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481672445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zhen Li, DNP, APRN, FNP-BC
• Jo Fu Liao
• Julia K Lichtenfels
• Life Solutions Counseling, PLLC
• Life Star of Michigan LLC
• Jessica Lightbody, CRNA
• Ariela Ligori
• Amy L Lilly
• Sha'Ziyah Lilly
• Abby Rose Lim

• Registered Nurse in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.