Provider Demographics
NPI:1629655758
Name:HOLLAND, LYNNE D
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:D
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 NORTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2010
Mailing Address - Country:US
Mailing Address - Phone:757-418-5099
Mailing Address - Fax:
Practice Address - Street 1:17 NORTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2010
Practice Address - Country:US
Practice Address - Phone:757-418-5099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide