MEDICARE: MRS. NYCOLE PETERSON HOLLINGTON 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	R151427	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558460287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NYCOLE PETERSON HOLLINGTON CRNP

Provider Business Mailing Address
First Line	:	11720 BELTSVILLE DR FL 9
Second Line	:
City	:	BELTSVILLE
State	:	MD
Zip	:	20705-3166
Country	:	US
Telephone Number	:	410-202-0004
Fax Number	:	650-376-4093

Provider Business Practice Location Address
First Line	:	11720 BELTSVILLE DR FL 9
Second Line	:
City	:	BELTSVILLE
State	:	MD
Zip	:	20705-3166
Country	:	US
Telephone Number	:	410-202-0004
Fax Number	:	650-376-4093

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	04/17/2025

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