Healthcare Provider Details

I. General information

NPI: 1376537738
Provider Name (Legal Business Name): CHERELL D HOLLADAY A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 HARD SCRABBLE RD
COLUMBIA SC
29229-9423
US

IV. Provider business mailing address

4310 HARD SCRABBLE RD
COLUMBIA SC
29229-9423
US

V. Phone/Fax

Practice location:
  • Phone: 352-217-2354
  • Fax:
Mailing address:
  • Phone: 352-217-2354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN091202
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 9194444
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3649
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: