Provider Demographics
NPI:1891404133
Name:HOLDING, KERRY ANN DESARIE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:KERRY ANN
Middle Name:DESARIE
Last Name:HOLDING
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 LONDON CREEK PL
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-2279
Mailing Address - Country:US
Mailing Address - Phone:407-799-1262
Mailing Address - Fax:
Practice Address - Street 1:2450 N ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-2316
Practice Address - Country:US
Practice Address - Phone:407-932-6163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9455383163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency