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General NPI Number Information
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NPI Number | 1982622965
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Entity Type | Individual
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Provider Name | VICKIE GAYLIN HOLLAND ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1011 HONOR HEIGHTS DR.
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City | MUSKOGEE
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State | OK
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Zip | 74401-1318
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Country | US
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Telephone | 918-683-3261
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Fax | 918-680-3664
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Provider Business Mailing Address
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Address Line | 1514 E. JOSEPH LANE
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City | FORT GIBSON
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State | OK
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Zip | 74434-8314
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Country | US
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Telephone | 918-478-3045
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Fax | 918-478-3045
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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 | R0032046
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License Number State | OK
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