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General NPI Number Information
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NPI Number | 1396303202
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Entity Type | Individual
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Provider Name | VICTORIA MARY KERRY HOLLOWAY
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Gender | Female
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 2100 STANTONSBURG RD
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City | GREENVILLE
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State | NC
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Zip | 27834-2818
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Country | US
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Telephone | 252-572-2391
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Fax |
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Provider Business Mailing Address
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Address Line | 4110 HERITAGE LAKE CT
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City | LUTZ
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State | FL
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Zip | 33558-9724
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Country | US
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Telephone | 813-391-6282
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5011817
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 26NJ15145600
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License Number State | NJ
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