Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN071958 | GA |
N | 363LA2100X | Nurse Practitioner - Acute Care | RN071958 | GA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN071958 | GA |
NPI | 1447652698 |
---|---|
Provider Name | Kathleen Holland |
First Address | Lawrenceville, GA 30046-1170 |
Second Address | Atlanta, GA 30308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2014 |
Last Update Date | 21/01/2019 |