Provider Demographics
NPI:1033369798
Name:HOLLOWAY, ERIN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3844 S LINDBERGH BLVD.
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-698-2500
Mailing Address - Fax:314-698-2323
Practice Address - Street 1:3844 S. LINDBERGH BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127
Practice Address - Country:US
Practice Address - Phone:314-698-2500
Practice Address - Fax:314-698-2323
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO133876363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health