Provider Demographics
NPI:1386857498
Name:HOLLINGSWORTH, DEENA B (NP)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:B
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8314 TRAFORD LN
Mailing Address - Street 2:STE C
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1661
Mailing Address - Country:US
Mailing Address - Phone:703-536-2729
Mailing Address - Fax:703-522-2482
Practice Address - Street 1:1005 N GLEBE RD
Practice Address - Street 2:SUITE 500
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5718
Practice Address - Country:US
Practice Address - Phone:703-536-2729
Practice Address - Fax:703-522-2482
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024079885363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS96291Medicare UPIN
VA004686M92Medicare PIN