MEDICARE: MRS. SARA HOLLAND CPNP

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	363LP0200X	Pediatric Nurse Practitioner	13301	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275768996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARA HOLLAND CPNP

Provider Business Mailing Address
First Line	:	PO BOX 15004
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37901-5004
Country	:	US
Telephone Number	:	865-541-8895
Fax Number	:	865-633-4808

Provider Business Practice Location Address
First Line	:	2100 CLINCH AVENUE SUITE 510
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-2225
Country	:	US
Telephone Number	:	658-244-9398
Fax Number	:	866-630-2013

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

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	06/21/2023

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