MEDICARE: COURTNEY HOLLOWAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	9502319	FL

General Provider Information

NPI Number	:	1235084526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY HOLLOWAY

Provider Business Mailing Address
First Line	:	33954 TERRAGONA DR
Second Line	:
City	:	SORRENTO
State	:	FL
Zip	:	32776-6919
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	53585 NOKOMIS RD
Second Line	:
City	:	ASHLAND
State	:	WI
Zip	:	54806-4272
Country	:	US
Telephone Number	:	715-682-7133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ COURTNEY HOLLOWAY ” Practice Location

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