Holly Churchill

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

201602402RN Issued in OR

Practice address

625 NE Galloway St
McMinnville, OR 97128-3933

Phone

(503) 434-7523

NPI assigned

Nov 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1043684756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NE 24TH ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971282105",
            "telephone_number": "971-901-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 NE GALLOWAY ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283933",
            "telephone_number": "503-434-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201602402RN",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "R 161857-2",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunisa Chanyaputhipong, MD
• Child & Adolescent Resource Center, LLC
• Zachery Paul Christenson
• Christopher a. Blake, MD, PC
• Carolee Church
• Kenneth M Cinnamon
• City of McMinnville
• Jessie Leigh Clark, APRNNP, FNPC, FNPBC
• Juliana Clark
• Nicholas L Clark, O.D.

• Psychiatric/Mental Health Registered Nurse in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Psychiatric/Mental Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.