MEDICARE: MRS. ELIZABETH A HOLDERNESS CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	R170415	MD

General Provider Information

NPI Number	:	1447480348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH A HOLDERNESS CRNP

Provider Business Mailing Address
First Line	:	7505 OSLER DR STE 302
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-7738
Country	:	US
Telephone Number	:	410-337-1783
Fax Number	:	410-427-2063

Provider Business Practice Location Address
First Line	:	7505 OSLER DR STE 302
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-7738
Country	:	US
Telephone Number	:	410-337-1783
Fax Number	:	410-427-2063

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2009
Last Update Date	:	01/15/2025

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