Provider Demographics
NPI:1346959376
Name:HOLLAND, MONNICQUE GABREILLE (RN BSN)
Entity Type:Individual
Prefix:
First Name:MONNICQUE
Middle Name:GABREILLE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8793 BLAKE EVAN CIR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-4452
Mailing Address - Country:US
Mailing Address - Phone:334-360-5705
Mailing Address - Fax:
Practice Address - Street 1:8793 BLAKE EVAN CIR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-4452
Practice Address - Country:US
Practice Address - Phone:334-360-5705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9506331163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscienceGroup - Multi-Specialty