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General NPI Number Information
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NPI Number | 1932931516
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Entity Type | Individual
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Provider Name | KEIMISHIA TERNACE HOLLOWAY PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 900 COMMONWEALTH PL # 200-1020
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4517
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Country | US
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Telephone | 757-752-8478
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Fax | 757-330-0797
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Provider Business Mailing Address
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Address Line | 900 COMMONWEALTH PL # 200-1020
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4517
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Country | US
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Telephone | 757-749-8507
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024190985
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License Number State | VA
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