Healthcare Provider Details

I. General information

NPI: 1851228704
Provider Name (Legal Business Name): MADISON C HOLLAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5441 BERRYHILL RD
MILTON FL
32570-8026
US

IV. Provider business mailing address

5642 JONES ST
MILTON FL
32570-2304
US

V. Phone/Fax

Practice location:
  • Phone: 850-626-7779
  • Fax: 850-626-7171
Mailing address:
  • Phone: 850-626-7779
  • Fax: 850-626-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11047284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: