Provider Demographics
NPI:1003200452
Name:MCFADDEN, HOLLY (CRNP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:915 LAWN AVE
Mailing Address - Street 2:SUIE 202
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1551
Mailing Address - Country:US
Mailing Address - Phone:215-453-3300
Mailing Address - Fax:215-453-3306
Practice Address - Street 1:915 LAWN AVE
Practice Address - Street 2:SUIE 202
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1551
Practice Address - Country:US
Practice Address - Phone:215-453-3300
Practice Address - Fax:215-453-3306
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014632363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
475653YABMMedicare PIN