Provider Demographics
NPI:1467646067
Name:HOLLAND, LINDA MARY (PHN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARY
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 MORRO BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93442-1918
Mailing Address - Country:US
Mailing Address - Phone:805-772-6385
Mailing Address - Fax:805-772-0520
Practice Address - Street 1:760 MORRO BAY BLVD
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-1918
Practice Address - Country:US
Practice Address - Phone:805-772-6385
Practice Address - Fax:805-772-0520
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN482268163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health