Provider Demographics
NPI:1053358911
Name:HETT, HOLLY A (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:HETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14655 GALAXIE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-8575
Mailing Address - Country:US
Mailing Address - Phone:952-432-6161
Mailing Address - Fax:952-432-7019
Practice Address - Street 1:14655 GALAXIE AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-8575
Practice Address - Country:US
Practice Address - Phone:952-432-6161
Practice Address - Fax:952-432-7019
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2020-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN41917207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine