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Credential/License Summary for 7182

Name: GOMEZ-LEVINE, HOLLY L
Profession: ADVANCED PRACTICE NURSE PRESCRIBER (33)
Credential/License Number: 7182-33
Location: ASHLAND WI
Credential/License Type: regular
Status: License is current (Active)
Eligible To Practice: credential license is current

Details
Requirements
Payments
Orders
Relationships

Credential/License current through: 9/30/2024
Granted date: 8/16/2016
Multi-state: N
Orders: NONE
Specialties: Adult Psychiatric/Mental Health, Child/Adolescent Psychiatric/Mental Hlth, Nurse Practitioner (NP)
Other Names: Holly L Gomez-Levine
Holly Gomez

Requirement Code Complied? Complied Date
Renewal Requirements for the year: 2022
FEE requirement complied 08/28/2022
INS requirement complied 08/28/2022
NTL requirement complied 08/28/2022
SIG requirement complied 08/28/2022
RNR requirement complied 08/11/2022
Renewal Year Amount Paid Payment Received
2022 57 08/28/2022

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ATTENTION: If a renewal application including payment is received by the renew by date (or Credential/License current through date), the credential holder is eligible to practice while the credential renewal is being processed. The credential holder must respond to any requests for information during the renewal process. See Wis. Stat. ยง 227.51(2).

Requirement Code Description

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