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General NPI Number Information
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NPI Number | 1962478412
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Entity Type | Individual
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Provider Name | CAROL EDWARDS HOLLAND CFNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 400 MILITARY HEIGHTS PL
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City | ROSWELL
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State | NM
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Zip | 88201-6407
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Country | US
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Telephone | 575-627-9500
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Fax | 575-627-9535
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Provider Business Mailing Address
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Address Line | 1112 N MAIN ST
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City | ROSWELL
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State | NM
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Zip | 88201-5010
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Country | US
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Telephone | 575-627-4200
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Fax | 575-627-4212
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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 | CNP00402
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License Number State | NM
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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 | R23239
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License Number State | NM
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