Provider Demographics
NPI:1508819848
Name:HOLLAND-HINTON, JENNIFER MARY (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARY
Last Name:HOLLAND-HINTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARY
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:885 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3800
Mailing Address - Country:US
Mailing Address - Phone:757-461-6342
Mailing Address - Fax:757-963-6158
Practice Address - Street 1:885 KEMPSVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3800
Practice Address - Country:US
Practice Address - Phone:757-461-6342
Practice Address - Fax:757-963-6158
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052905208000000X
NC200100699208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
5417787860408EOtherCIGNA INSURANCE
447376OtherMDIPA INSURANCE
5238479OtherAETNA INSURANCE
541778786OtherUNITED HEALTH CARE INS
VA006706959Medicaid
VA319792OtherANTHEM BCBS INSURANCE
40522OtherOPTIMA INSURANCE
VA006706959Medicaid