Provider Demographics
NPI:1083049738
Name:HOLLADAY, DIANE S (APRN-C)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:S
Last Name:HOLLADAY
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:S
Other - Last Name:NAPIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5610 FLETCHER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-1432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5610 FLETCHER OAKS DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32317-1432
Practice Address - Country:US
Practice Address - Phone:850-570-3620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9224016363LF0000X
FLARNP9224016363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014968600Medicaid
FL014968600Medicaid