Holly C Hacking, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

327253-4405 Issued in UT

Practice address

1611 W 2450 N
Vernal, UT 84078-9651

Phone

(435) 790-3347

NPI assigned

May 10, 2021

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)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADJDDD/Endpoint/ADJDDD

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.

• Pettit Pediatrics LLC

  • Pediatrics Physician
  • Vernal, UT
  • NPI 1518435452
  NPD (past)

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1053995688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W 2450 N",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840789651",
            "telephone_number": "435-790-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W 2450 N",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840789651",
            "telephone_number": "435-790-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKING",
        "first_name": "HOLLY",
        "middle_name": "C",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "327253-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "327253-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Gowen, LCSW
• Dylan Graff, LCSW
• Jennifer Green
• Kira Greene
• John Griffith, MD
• Chelsie Hall
• Laura L Hall, LCSW
• Robert D Hall, LCSW
• Eldon Brent Hamelin
• Teri Hancock

• Family Nurse Practitioner in Vernal, UT
• Providers in Vernal, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.