Provider Demographics
NPI:1235321696
Name:HOLLADAY, RENDA JOY (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RENDA
Middle Name:JOY
Last Name:HOLLADAY
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 W 38TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1016
Mailing Address - Country:US
Mailing Address - Phone:512-324-3380
Mailing Address - Fax:
Practice Address - Street 1:1301 W 38TH ST STE 700
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1016
Practice Address - Country:US
Practice Address - Phone:512-324-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115660363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX298557YMP3OtherMEDICARE
TX2127763-02Medicaid