Provider Demographics
NPI:1306006754
Name:CARROLL-HOLOWAY, CYNTHIA E (ARNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:CARROLL-HOLOWAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-5705
Mailing Address - Country:US
Mailing Address - Phone:850-416-4189
Mailing Address - Fax:850-416-4872
Practice Address - Street 1:5151 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5705
Practice Address - Country:US
Practice Address - Phone:850-416-4189
Practice Address - Fax:850-416-4872
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP930972363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303081400Medicaid