Holly Husted, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704199043 Issued in MI

Practice address

803 W Arlington St
Bangor, MI 49013-1108

Phone

(269) 427-6810

Fax

(269) 657-6523

NPI assigned

Jan 5, 2007

Last updated

Mar 12, 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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

• County of Calhou

  dba Student Health Center

  • Public Health or Welfare Agency
  • Battle Creek, MI
  • NPI 1750474839
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1750438214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HAZEN ST STE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490792008",
            "telephone_number": "269-655-3334",
            "fax_number": "269-657-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W ARLINGTON ST",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490131108",
            "telephone_number": "269-427-6810",
            "fax_number": "269-657-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTED",
        "first_name": "HOLLY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704199043",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704199043",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750438214",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BMG",
            "identifier": "1801818752",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rickie Lynn Hernandez
• Craig Michael Herrmann, D.D.S.
• Laurie Hixson
• Hometown Pharmacy Inc (Swanstra Pharmacy)
• Amy Howay
• Intercare Community Health Network
• Intercare Community Health Network
• Intercare Community Health Network
• Intercare Community Health Network Dental Van
• Intercare Community Heath Network Medical Van

• Nurse Practitioner in Bangor, MI
• Providers in Bangor, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.