Provider Demographics
NPI:1417732025
Name:JANDA, HOLLY MICHELLE (CD(DONA))
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:MICHELLE
Last Name:JANDA
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 MARINA BAY DR
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-5318
Mailing Address - Country:US
Mailing Address - Phone:386-576-6914
Mailing Address - Fax:
Practice Address - Street 1:135 MARINA BAY DR
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169-5318
Practice Address - Country:US
Practice Address - Phone:386-576-6914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15103374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula