Provider Demographics
NPI:1659136430
Name:HOLLIMON-SAFFOLD, TOMEACA (FNP-C)
Entity Type:Individual
Prefix:
First Name:TOMEACA
Middle Name:
Last Name:HOLLIMON-SAFFOLD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BRIERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7768
Mailing Address - Country:US
Mailing Address - Phone:228-229-6674
Mailing Address - Fax:
Practice Address - Street 1:114 BRIERFIELD DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-7768
Practice Address - Country:US
Practice Address - Phone:228-229-6674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily