Healthcare Provider Details

I. General information

NPI: 1386913366
Provider Name (Legal Business Name): HOLLY LYNN MACHANIC-ADOLFI R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY LYNN ADOLFI R.N.

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CHARLESTON CENTER DR
CHARLESTON SC
29401-1162
US

IV. Provider business mailing address

109 CARRIAGE RIDE LN
SUMMERVILLE SC
29485-7865
US

V. Phone/Fax

Practice location:
  • Phone: 843-579-4577
  • Fax:
Mailing address:
  • Phone: 843-579-4577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN .220864 R
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number491262-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: