Provider Demographics
NPI:1649207424
Name:HOLLAND, AIMEE CHISM (CRNP)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:CHISM
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55845
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5845
Mailing Address - Country:US
Mailing Address - Phone:205-279-2860
Mailing Address - Fax:
Practice Address - Street 1:1515 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1601
Practice Address - Country:US
Practice Address - Phone:205-279-2860
Practice Address - Fax:205-252-0197
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1096935363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051521393OtherBLUE CROSS
AL051524693OtherBLUE CROSS
AL891007650Medicaid
AL891007660Medicaid
AL051521394OtherBLUE CROSS
AL891007600Medicaid
AL891007640Medicaid
AL891009090Medicaid
AL051521402OtherBLUE CROSS
AL051521395OtherBLUE CROSS
AL891007610Medicaid
AL051521401OtherBLUE CROSS
AL051524692OtherBLUE CROSS
AL891007620Medicaid
AL891009070Medicaid
AL051521396OtherBLUE CROSS
AL891007630Medicaid
AL051524691OtherBLUE CROSS
AL051521400OtherBLUE CROSS
AL891009080Medicaid