Provider Demographics
NPI:1164427605
Name:HOLLAND-OJEDA, LINDA LOU (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LOU
Last Name:HOLLAND-OJEDA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 W THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4240
Mailing Address - Country:US
Mailing Address - Phone:602-254-0390
Mailing Address - Fax:602-254-0760
Practice Address - Street 1:521 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4240
Practice Address - Country:US
Practice Address - Phone:602-254-0390
Practice Address - Fax:602-254-0760
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ860627963OtherEIN