Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lori Holaly, NP-C

Individual provider Adult Health Nurse Practitioner · NPI 1194337881

Lori Holaly, NP-C is a Nurse Practitioner in Detroit, Michigan. Qualified in 2020, 6 years ago. Practices with Henry Ford Health St John Hospital, a 330-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado and Michigan.

Years since qualifying
6
Licensed in
CO, MI
In the registry since
2020
Specialties on file
2
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

22101 Moross Rd Ste 212
Detroit, MI 48236-2148
Phone: (313) 343-4921
Fax: (313) 343-7091
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12605 E 16th Ave, Aurora, CO 80045-2545 — (720) 777-1234

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704302239 (MI)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence APN.0996958-NP (CO)

Record details

NPI number1194337881
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedAugust 23, 2020
Last updated in NPPESAugust 16, 2024
Certification dateAugust 16, 2024
Mailing addressPo Box 110429, Aurora, CO 80042-0429

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Henry Ford Health St. John Hospital — 330 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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