Healthcare Provider Details

I. General information

NPI: 1780599019
Provider Name (Legal Business Name): JOEL HOLLAND FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 EAGLES LANDING PKWY
STOCKBRIDGE GA
30281-5085
US

IV. Provider business mailing address

11044 ALPHARETTA HWY APT 2306
ROSWELL GA
30076-5744
US

V. Phone/Fax

Practice location:
  • Phone: 678-604-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP279225
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: