Healthcare Provider Details

I. General information

NPI: 1326806894
Provider Name (Legal Business Name): HOLLY CHRISTINA DORRANCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY CHRISTINA ARCENEAUX

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 O ST NW
WASHINGTON DC
20057-0003
US

IV. Provider business mailing address

1800 N OAK ST APT 402
ARLINGTON VA
22209-2607
US

V. Phone/Fax

Practice location:
  • Phone: 202-687-0100
  • Fax:
Mailing address:
  • Phone: 971-291-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60649543
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN500006221
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: