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General NPI Number Information
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NPI Number | 1437046786
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Entity Type | Individual
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Provider Name | REGINA ANN HOLLIDAY
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Gender | Female
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 12504 MART CT
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-5636
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Country | US
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Telephone | 202-674-4648
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Fax | 301-249-4230
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Provider Business Mailing Address
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Address Line | 12504 MART CT
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-5636
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Country | US
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Telephone | 202-674-4648
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Fax | 301-249-4230
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | H430734067679
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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