Provider Demographics
NPI:1295272185
Name:HOLLOWAY, KERRI (APRN)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 W CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5409
Mailing Address - Country:US
Mailing Address - Phone:410-546-0464
Mailing Address - Fax:
Practice Address - Street 1:314 W CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5409
Practice Address - Country:US
Practice Address - Phone:410-546-0464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR199383363LF0000X
DELG-0001017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily