Provider Demographics
NPI:1568686681
Name:HOLLAND, DEBORAH FERLITA (CNM)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:FERLITA
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:FERLITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 E. MEDICAL LANE
Practice Address - Street 2:SUITE 300
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4801
Practice Address - Country:US
Practice Address - Phone:803-936-8100
Practice Address - Fax:803-936-8130
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3016367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAPRN 3016OtherLICENSE