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General NPI Number Information
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NPI Number | 1811783509
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Entity Type | Individual
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Provider Name | REBECCA LAUREN HOLLOWAY
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Gender | Female
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 275 COLLIER RD NW STE 300
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City | ATLANTA
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State | GA
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Zip | 30309-1740
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Country | US
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Telephone | 404-350-0009
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Fax | 404-350-0280
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Provider Business Mailing Address
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Address Line | 1170 KEENELAND DR
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City | BOGART
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State | GA
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Zip | 30622-4594
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Country | US
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Telephone | 919-809-2275
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN222989
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN222989
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License Number State | GA
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