Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 466366 | CA |
NPI | 1003830878 |
---|---|
Provider Name | Patricia R Holland |
First Address | Vista, CA 92084-5218 |
Second Address | Vista, CA 92084-5218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 22/09/2010 |