Active NPI
Holly Whitehurst Braddy, LPN
- Licensed Practical Nurse
- Greenville, NC
National Provider Identifier
1679450225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 75704
- Practice address
- 2070 W Arlington Blvd
Greenville, NC 27834-3769 - Phone
- (252) 565-8021
- NPI assigned
- Aug 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 75704 | NC | Primary |
Addresses
Primary practice location
2070 W Arlington Blvd
Greenville, NC 27834-3769
Mailing address
103 N Reed Dr
Washington, NC 27889-3247
Phone (252) 495-3865
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75704 | NC | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755475200000",
"number": "1679450225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 N REED DR",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "278893247",
"telephone_number": "252-495-3865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2070 W ARLINGTON BLVD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278343769",
"telephone_number": "252-565-8021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADDY",
"first_name": "HOLLY",
"middle_name": "WHITEHURST",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-18",
"last_updated": "2025-08-18",
"certification_date": "2025-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NC",
"license": "75704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.