Healthcare Provider Details

I. General information

NPI: 1376760934
Provider Name (Legal Business Name): LAURA JUNE HOLLOWAY NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 SAVANNAH RD
LEWES DE
19958-1462
US

IV. Provider business mailing address

33663 BAYVIEW MEDICAL DR UNIT 1
LEWES DE
19958-1663
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3535
  • Fax: 302-645-3691
Mailing address:
  • Phone: 302-645-3555
  • Fax: 302-644-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberLM-0000137
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: