Provider Demographics
NPI:1215560255
Name:HOLLAND, ADRIENNE M (AGNP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:M
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 N PUTNAM PT
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-5352
Mailing Address - Country:US
Mailing Address - Phone:352-436-2701
Mailing Address - Fax:
Practice Address - Street 1:2347 N PUTNAM PT
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-5352
Practice Address - Country:US
Practice Address - Phone:352-436-2701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0134491363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner