Healthcare Provider Details

I. General information

NPI: 1417043563
Provider Name (Legal Business Name): MARGARET ANN HOLLINGSWORTH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 PINE ST
SYLVANIA GA
30467-2036
US

IV. Provider business mailing address

416 PINE ST
SYLVANIA GA
30467-2036
US

V. Phone/Fax

Practice location:
  • Phone: 912-564-2182
  • Fax: 912-564-7887
Mailing address:
  • Phone: 912-564-2182
  • Fax: 912-564-7887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN074492
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: