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General NPI Number Information
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NPI Number | 1003045410
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Entity Type | Individual
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Provider Name | PATSY LENAN HOLLOWAY FNP BC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 605 S ARCHUSA AVE
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City | QUITMAN
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State | MS
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Zip | 39355-2331
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Country | US
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Telephone | 601-776-6925
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Fax | 601-776-7148
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Provider Business Mailing Address
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Address Line | 503 LYNDA ST
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City | QUITMAN
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State | MS
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Zip | 39355-2432
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Country | US
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Telephone | 601-776-6925
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Fax | 601-776-7148
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R847138
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License Number State | MS
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