Provider Demographics
NPI:1114116704
Name:HOLLAND, MARTHA ANN (RD)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:ANN
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 WELLS FARGO RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89508-8102
Mailing Address - Country:US
Mailing Address - Phone:775-972-6220
Mailing Address - Fax:
Practice Address - Street 1:10300 WELLS FARGO RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89508-8102
Practice Address - Country:US
Practice Address - Phone:775-972-6220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered