Provider Demographics
NPI:1912561051
Name:HOLT, PRINCESS ROLLINS (CNS)
Entity Type:Individual
Prefix:
First Name:PRINCESS
Middle Name:ROLLINS
Last Name:HOLT
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 SWAN FOREST DR APT B
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-2046
Mailing Address - Country:US
Mailing Address - Phone:918-219-9400
Mailing Address - Fax:
Practice Address - Street 1:2300 HIGHLAND VILLAGE RD STE 300
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7157
Practice Address - Country:US
Practice Address - Phone:972-318-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141395364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty