Provider Demographics
NPI:1811645526
Name:HOLLAND, HEATHER NICOLE (CNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICOLE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:DOCKENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 CHARLES JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-6246
Mailing Address - Country:US
Mailing Address - Phone:320-237-3795
Mailing Address - Fax:
Practice Address - Street 1:43 LEWIS BAY RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5235
Practice Address - Country:US
Practice Address - Phone:774-552-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8790363L00000X
MARN2366153163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner