Provider Demographics
NPI:1417394750
Name:HOLLAND, YVETTE CRAWLEY (CRNP)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:CRAWLEY
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 CHAFF WAY
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3278
Mailing Address - Country:US
Mailing Address - Phone:301-704-2919
Mailing Address - Fax:301-560-2333
Practice Address - Street 1:10095 WARD RD
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-2731
Practice Address - Country:US
Practice Address - Phone:240-459-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR167796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily