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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

KRISTY HOLLY LPN
NPI 1023931672
Custodial Care Facility - Adult Care Home in Kelso, WA

Active since July 31, 2026
205 PELICAN DR, KELSO, WA 98626(360) 353-5717(360) 998-3420 Get Directions Write a Review

NPPES record added: July 31, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kristy Holly Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTY HOLLY LPN (NPI 1023931672) is an individual adult care home provider in Kelso, Washington, licensed in Washington (753805) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1023931672
Entity TypeIndividualFemale
Primary Taxonomy311ZA0620X
Provider Legal NameKRISTY HOLLYCredential: LPN
Location Address205 PELICAN DRKelso, WA 98626-5811
Mailing Address205 Pelican DrKelso, WA 98626-5811 · (360) 353-5717 · Fax (360) 998-3420
Phone(360) 353-5717
Fax(360) 998-3420
Sole ProprietorYes
Enumeration DateJuly 31, 2026
NPPES CertifiedJuly 31, 2026
✔ NPI 1023931672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in WA · 753805
Definition
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.
205 PELICAN DR, Kelso, WA 98626
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristy Holly's NPI number?

The NPI number for Kristy Holly is 1023931672. It was assigned to this individual provider in the NPPES registry on July 31, 2026.

Where is Kristy Holly located?

Kristy Holly practices at 205 Pelican Dr, Kelso, WA 98626. The listed phone number is (360) 353-5717.

What is Kristy Holly's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Kristy Holly was last updated on July 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.