Provider Demographics
NPI:1295408581
Name:NILSSON, HOLLY (CRNP-FAMILY)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:NILSSON
Suffix:
Gender:F
Credentials:CRNP-FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7250 PARKWAY DRIVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:
Practice Address - Street 1:7250 PARKWAY DRIVE
Practice Address - Street 2:SUITE 500
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076
Practice Address - Country:US
Practice Address - Phone:443-949-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-01
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily