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General NPI Number Information
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NPI Number | 1407288053
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Entity Type | Individual
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Provider Name | PATRICE MARLENE HOLLIDAY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 4401 CORTEZ RD W
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City | BRADENTON
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State | FL
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Zip | 34210-3142
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Country | US
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Telephone | 941-357-5550
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Fax | 941-792-7152
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Provider Business Mailing Address
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Address Line | 7611 25TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-5236
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Country | US
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Telephone | 941-376-1944
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN18610
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9232802
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2016035060
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11013337
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License Number State | FL
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