HOLLEY GULLICKSON – Nurse Practitioner, NPI 1023025517

HOLLEY GULLICKSON is a healthcare provider. based in Robbinsdale, Minnesota. specializing in NURSE PRACTITIONER. They hold a License No. R1551082 (MN). The NPI Number for HOLLEY GULLICKSON is 1023025517

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
HOLLEY GULLICKSON
NPI
1023025517
Phone
Not provided
Address
3366 OAKDALE AVE N
Enumeration Date
1 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7372266700
Graduation Year
2005 (21 years ago)
PAC ID
0345255535
Group Practice PAC ID
6305233461
Professional Enrollment ID
I20060208000845
Address ID
MN554372040MI5123XSTXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

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Provider Addresses for HOLLEY GULLICKSON

  • Oakdale Medical Building, 3366, Oakdale Avenue North, Robbinsdale, Hennepin County, Minnesota, 55422, United States

    SUITE 605

    ROBBINSDALE, MN 554222948

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-02-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060208000845INurse PractitionerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes2121$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes1615$0
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 55422)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305233461View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineIA
Emergency MedicineMN
Nurse PractitionerWI
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerMN
Physician AssistantMN
Nurse PractitionerMN
Nurse PractitionerSD
Nurse PractitionerMN

Reviews

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Frequently asked questions

How do payers reference HOLLEY GULLICKSON?
For HOLLEY GULLICKSON, use NPI 1023025517 as the unique 10-digit identifier.
Is HOLLEY GULLICKSON shown as active in public data?
Registry records indicate HOLLEY GULLICKSON maintains an active NPI.
What clinical focus is listed for HOLLEY GULLICKSON?
At a glance, HOLLEY GULLICKSON is tied to Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with HOLLEY GULLICKSON?
Directory geography for HOLLEY GULLICKSON centers on Robbinsdale, Minnesota.
Can I trust this NPI listing for HOLLEY GULLICKSON?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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