Provider Demographics
NPI:1922430602
Name:HOLLOWAY DOUGLAS, CAREY LAUREN (NP-C)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:LAUREN
Last Name:HOLLOWAY DOUGLAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1928
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-1928
Mailing Address - Country:US
Mailing Address - Phone:334-793-8087
Mailing Address - Fax:334-793-8191
Practice Address - Street 1:101 PROFESSIONAL LN
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2085
Practice Address - Country:US
Practice Address - Phone:334-347-3404
Practice Address - Fax:334-393-0613
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-125453363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily