Provider Demographics
NPI:1043678550
Name:VALENTINE, HOLLY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4313 BLUEBONNET BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9679
Mailing Address - Country:US
Mailing Address - Phone:225-960-1580
Mailing Address - Fax:225-960-1909
Practice Address - Street 1:4313 BLUEBONNET BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9679
Practice Address - Country:US
Practice Address - Phone:225-960-1580
Practice Address - Fax:225-960-1909
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily