Provider Demographics
NPI:1457680498
Name:HOLLOWAY, DEVON D (NP-C)
Entity Type:Individual
Prefix:MS
First Name:DEVON
Middle Name:D
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 BARRANCA PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1723
Mailing Address - Country:US
Mailing Address - Phone:949-559-1911
Mailing Address - Fax:949-559-4071
Practice Address - Street 1:4050 BARRANCA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-1723
Practice Address - Country:US
Practice Address - Phone:949-559-1911
Practice Address - Fax:949-559-4071
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18988363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health