Provider Demographics
NPI:1750994760
Name:HOLDERFIELD, HOLLIE SUE (FNP)
Entity type:Individual
Prefix:MRS
First Name:HOLLIE
Middle Name:SUE
Last Name:HOLDERFIELD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:HOLLIE
Other - Middle Name:SUE
Other - Last Name:SIGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1150 STATE HIGHWAY 248 STE 100
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-4186
Mailing Address - Country:US
Mailing Address - Phone:417-348-8655
Mailing Address - Fax:417-239-2920
Practice Address - Street 1:1150 STATE HIGHWAY 248 STE 100
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-4186
Practice Address - Country:US
Practice Address - Phone:417-348-8655
Practice Address - Fax:417-239-2920
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020027894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily