Provider Demographics
NPI:1205681228
Name:HOLLOWAY, ADRIENNE LOUISE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LOUISE
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:LOUISE
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:170 LARKINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-6009
Mailing Address - Country:US
Mailing Address - Phone:757-927-6550
Mailing Address - Fax:
Practice Address - Street 1:1631 MIDTOWN PL STE 104-110
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-1300
Practice Address - Country:US
Practice Address - Phone:336-355-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019958363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health