Provider Demographics
NPI:1184834731
Name:HOLDREDGE, ANN (CNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:HOLDREDGE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 EDDY ST
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4941
Mailing Address - Country:US
Mailing Address - Phone:401-272-1550
Mailing Address - Fax:401-421-8792
Practice Address - Street 1:695 EDDY ST
Practice Address - Street 2:SUITE 21
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4941
Practice Address - Country:US
Practice Address - Phone:401-272-1550
Practice Address - Fax:401-421-8792
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP18806363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health