Provider Demographics
NPI:1689641524
Name:HOLNESS, GISELLE (ARNP)
Entity Type:Individual
Prefix:DR
First Name:GISELLE
Middle Name:
Last Name:HOLNESS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS
Mailing Address - Street 2:1536 NORTH JEFFERSON STREET
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-5870
Mailing Address - Country:US
Mailing Address - Phone:305-790-7177
Mailing Address - Fax:
Practice Address - Street 1:1536 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6525
Practice Address - Country:US
Practice Address - Phone:305-790-7177
Practice Address - Fax:305-790-7177
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2900482363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP64056Medicare UPIN
FLE7798ZMedicare ID - Type Unspecified