MEDICARE: CATHERINE A HOLLAND CRNA

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	367500000X	Certified Registered Nurse Anesthetist	129690	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	129690	OTHER	TN	RN LICENSE #

General Provider Information

NPI Number	:	1841269370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE A HOLLAND CRNA

Provider Business Mailing Address
First Line	:	95429 BARNWELL RD
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-1698
Country	:	US
Telephone Number	:	904-321-3533
Fax Number	:	517-787-7365

Provider Business Practice Location Address
First Line	:	95429 BARNWELL RD
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-1698
Country	:	US
Telephone Number	:	904-321-3533
Fax Number	:	517-787-7365

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	05/20/2013

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Directions to “ CATHERINE A HOLLAND CRNA” Practice Location

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