Healthcare Provider Details

I. General information

NPI: 1922910330
Provider Name (Legal Business Name): HOLLY LEA MCLAURIN SIMMONS MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2383 OLD STATE RD
SWANSEA SC
29160-8358
US

IV. Provider business mailing address

2383 OLD STATE RD
SWANSEA SC
29160-8358
US

V. Phone/Fax

Practice location:
  • Phone: 803-673-3741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32810
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: