Provider Demographics
NPI:1528540960
Name:HOLIDAY, SHANA SAVITA (RN, MSN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:SHANA
Middle Name:SAVITA
Last Name:HOLIDAY
Suffix:
Gender:F
Credentials:RN, MSN, CDCES
Other - Prefix:MISS
Other - First Name:SHANA
Other - Middle Name:SAVITA
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:951 ISHA LN
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-8627
Mailing Address - Country:US
Mailing Address - Phone:619-602-7286
Mailing Address - Fax:
Practice Address - Street 1:951 ISHA LN
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-8627
Practice Address - Country:US
Practice Address - Phone:619-602-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-01
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN253021163WC0400X, 163WC1500X, 163WD0400X, 163WN1003X, 171400000X, 174H00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator