Provider Demographics
NPI:1568803286
Name:HOLLYWOOD, LAURA ANN (CNM, FNP, WHCP, ARNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:HOLLYWOOD
Suffix:
Gender:F
Credentials:CNM, FNP, WHCP, ARNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2024 SW 44TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6207
Mailing Address - Country:US
Mailing Address - Phone:845-597-6051
Mailing Address - Fax:
Practice Address - Street 1:4250 HATTON ROGERS LN
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7813
Practice Address - Country:US
Practice Address - Phone:239-656-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9363011363LA2200X
NYF335124-1363LA2200X
NYF420883-1363LW0102X
NYF000739-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife