MEDICARE: TERRAN DARNELL HOLLAND

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1336035765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRAN DARNELL HOLLAND

Provider Business Mailing Address
First Line	:	441 HERMAN AVE
Second Line	:
City	:	STAR CITY
State	:	WV
Zip	:	26505-2055
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3206 UNIVERSITY COMMONS DR
Second Line	:
City	:	STAR CITY
State	:	WV
Zip	:	26505-0209
Country	:	US
Telephone Number	:	681-209-1314
Fax Number	:

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

Provider Enumeration Date	:	06/13/2025
Last Update Date	:	06/13/2025

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Directions to “ TERRAN DARNELL HOLLAND ” Practice Location

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