Provider Demographics
NPI:1740269661
Name:HOLLAND, ROBYN M (PAC)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:M
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MRS
Other - First Name:ROBYN
Other - Middle Name:MANN
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:3833 RIDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2547
Mailing Address - Country:US
Mailing Address - Phone:410-726-7416
Mailing Address - Fax:
Practice Address - Street 1:3833 RIDERWOOD DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-2547
Practice Address - Country:US
Practice Address - Phone:410-726-7416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002898363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS450Medicaid
P47856Medicare UPIN
MDS450Medicaid