Provider Demographics
NPI:1780864439
Name:REGISTER, HOLLY G (RN, MS, FNP)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:G
Last Name:REGISTER
Suffix:
Gender:F
Credentials:RN, MS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2050 HILLPOINT BLVD N
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-7181
Mailing Address - Country:US
Mailing Address - Phone:757-934-3434
Mailing Address - Fax:757-538-9038
Practice Address - Street 1:2050 HILLPOINT BLVD N
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-7181
Practice Address - Country:US
Practice Address - Phone:757-934-3434
Practice Address - Fax:757-538-9038
Is Sole Proprietor?:No
Enumeration Date:2007-11-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024067273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMR0982377OtherSTATE OF VIRGINIA DEA