=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376760934
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA JUNE HOLLOWAY NNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2007
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 424 SAVANNAH RD
-----------------------------------------------------
City | LEWES
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19958-1462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-645-3535
-----------------------------------------------------
Fax | 302-645-3691
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33663 BAYVIEW MEDICAL DR UNIT 1
-----------------------------------------------------
City | LEWES
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19958-1663
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-645-3555
-----------------------------------------------------
Fax | 302-644-3560
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LN0005X
-----------------------------------------------------
Taxonomy Name | Critical Care Neonatal Nurse Practitioner
-----------------------------------------------------
License Number | LM-0000137
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------