Provider Demographics
NPI:1992680151
Name:BOWLDS, HOLLY (FNP-C)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:BOWLDS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-6095
Mailing Address - Country:US
Mailing Address - Phone:480-299-4739
Mailing Address - Fax:
Practice Address - Street 1:1160 EVANS ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-6095
Practice Address - Country:US
Practice Address - Phone:480-299-4739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY57174363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner