Holly Rebecca Etheredge, APRN in Longview, TX

Holly Rebecca Etheredge, APRN is a medicare enrolled "Nurse Practitioner" in Longview, Texas. Her current practice location is 700 E Marshall Ave, Longview, Texas. You can reach out to her office (for appointments etc.) via phone at (903) 315-1500.

Holly Rebecca Etheredge is licensed to practice in Texas (license number 1099410) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1538878053.

Contact Information

	Holly Rebecca Etheredge, APRN
	700 E Marshall Ave, Longview, TX 75601-5580
	(903) 315-1500
	Not Available

Map and Direction

Provider's Profile

Full Name	Holly Rebecca Etheredge
Gender	Female
Speciality	Nurse Practitioner
Location	700 E Marshall Ave, Longview, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1538878053
Provider Enumeration Date: 11/23/2022
Last Update Date: 01/17/2023

Medicare PECOS Information:

PECOS PAC ID: 4183095151
Enrollment ID: I20230131000095

Medical Identifiers

Medical identifiers for Holly Rebecca Etheredge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1538878053	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	1099410 (Texas)	Secondary
363L00000X	Nurse Practitioner	1099410 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Holly Rebecca Etheredge allows following entities to bill medicare on her behalf.

Entity Name	Christus Trinity Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091

Entity Name	North Texas Physician Services, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1992586150 PECOS PAC ID: 6305295429 Enrollment ID: O20231213004113

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holly Rebecca Etheredge is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Holly Rebecca Etheredge, APRN 3546 Fm 959, Beckville, TX 75631-6883 Ph: (936) 645-8598	Holly Rebecca Etheredge, APRN 700 E Marshall Ave, Longview, TX 75601-5580 Ph: (903) 315-1500

Reviews and Comments

Nurse Practitioner Nurses in Longview, TX

Sarah Faye Earnest, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 410 N 4th St, Longview, TX 75601 Phone: 903-234-8808 Fax: 903-234-9769
Christina Lea Croley, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 701 E Marshall Ave Ste 200, Longview, TX 75601 Phone: 903-236-2222
Dorothy Mckenzie Womack, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3535 N Fourth St Ste 400, Longview, TX 75605 Phone: 903-757-3881 Fax: 903-757-5948
Mary Mckenzie, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2021 W Loop 281, Longview, TX 75604 Phone: 903-295-1396
Ms. Erica O Salami, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 703 E Marshall Ave Ste 4003, Longview, TX 75601 Phone: 903-315-2032
Jennifer Borrego, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 700 E Marshall Ave, Longview, TX 75601 Phone: 903-315-1488 Fax: 903-315-1656
Christy Anne Cobb, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 707 Hollybrook Dr, Longview, TX 75605 Phone: 903-291-6223 Fax: 903-291-6222

Holly Rebecca Etheredge, APRN - Medicare Nurse Practitioner in Longview, TX