Holly Marie Lackey, RN

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

795338 Issued in TX

Practice address

176 VZCR 4714
Ben Wheeler, TX 75754-0422

Phone

(903) 279-6547

NPI assigned

Jul 26, 2019

Last updated

Jul 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1407400666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 422",
            "city": "BEN WHEELER",
            "state": "TX",
            "postal_code": "757540422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 VZCR 4714",
            "city": "BEN WHEELER",
            "state": "TX",
            "postal_code": "757540422",
            "telephone_number": "903-279-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "795338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Nicole Grigsby, LCDC
• Kristina Marie Henry
• Shila Marie Hoffman
• Abigale Hooper, PT, DPT
• Carissa Diane Hunter, M.S. CCC-SLP
• Gustavo Eloy Lemus, DC
• Martins Mill I S D
• Next Level Health and Wellness PLLC
• Ashlea Elizabeth Perkins, LPC, LCDC,NCC
• Melinda Salem-Jackson, NCTMB, LMT, CMMT

• Pediatric Registered Nurse in Ben Wheeler, TX
• Providers in Ben Wheeler, TX by specialty
• Pediatric Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.