Provider Demographics
NPI:1861420549
Name:TURBYFILL, HOLLY IDOL (NP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:IDOL
Last Name:TURBYFILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:NC
Mailing Address - Zip Code:27370-0667
Mailing Address - Country:US
Mailing Address - Phone:336-880-2419
Mailing Address - Fax:
Practice Address - Street 1:2203 EASTCHESTER DR STE 105
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1519
Practice Address - Country:US
Practice Address - Phone:336-880-2419
Practice Address - Fax:949-437-8484
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-01817363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004767Medicaid
NC2592658AMedicare PIN
NC2592658Medicare PIN