KRISTY HOLLY LPN NPI 1023931672

NPI Information

  • NPI: 1023931672
  • Provider Name: KRISTY HOLLY, LPN
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Individual
  • Address: 205 PELICAN DR
    KELSO, WA
    ZIP 98626
  • Phone: (360) 353-5717

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NPI Details

Kristy Holly, LPN is an adult care home custodial care facility in Kelso, WA. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. Kristy Holly, LPN NPI is 1023931672. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

205 PELICAN DR
KELSO, WA
ZIP 98626-811
Phone: (360) 353-5717
Fax: (360) 998-3420

The enumeration date for this NPI number is 7/31/2026 and was last updated on 7/31/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care Home753805WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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