Healthcare Provider Details

I. General information

NPI: 1740717065
Provider Name (Legal Business Name): ANNSLEY CAMILLE HOLLAND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 CONCORD ST
FRAMINGHAM MA
01701-4613
US

IV. Provider business mailing address

76 BATTERSON PARK RD STE 106
FARMINGTON CT
06032-2571
US

V. Phone/Fax

Practice location:
  • Phone: 203-598-6045
  • Fax:
Mailing address:
  • Phone: 203-598-6045
  • Fax: 203-879-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0112086
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: