Provider Demographics
NPI:1619468212
Name:HOLLAND, MCKENNA L (CNP)
Entity Type:Individual
Prefix:
First Name:MCKENNA
Middle Name:L
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 BRECKSVILLE RD STE 10
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5057
Mailing Address - Country:US
Mailing Address - Phone:440-989-4874
Mailing Address - Fax:
Practice Address - Street 1:6801 BRECKSVILLE RD STE 10
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-5057
Practice Address - Country:US
Practice Address - Phone:216-444-4663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-20
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022439363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care