Provider Demographics
NPI:1942593405
Name:HOLC, MARY P (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:P
Last Name:HOLC
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:500 HIOAKS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4061
Mailing Address - Country:US
Mailing Address - Phone:804-560-0490
Mailing Address - Fax:804-560-3424
Practice Address - Street 1:500 HIOAKS RD
Practice Address - Street 2:SUITE B
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4061
Practice Address - Country:US
Practice Address - Phone:804-560-0490
Practice Address - Fax:804-560-3424
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2015-02-03
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Provider Licenses
StateLicense IDTaxonomies
VA0024169406363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0603180002Medicare NSC