Provider Demographics
NPI:1780165159
Name:HOLLINGSWORTH, ALICIA ANN (CRNP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANN
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:GREEN LANE
Mailing Address - State:PA
Mailing Address - Zip Code:18054-9551
Mailing Address - Country:US
Mailing Address - Phone:610-389-0314
Mailing Address - Fax:
Practice Address - Street 1:1831 SWAMP PIKE STE 202
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-8927
Practice Address - Country:US
Practice Address - Phone:610-323-5415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA20188482208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics