Provider Demographics
NPI:1912769050
Name:HOLLAND, LLOYD RICHARD
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:RICHARD
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 HAMILTON ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6431
Mailing Address - Country:US
Mailing Address - Phone:202-491-9980
Mailing Address - Fax:
Practice Address - Street 1:1490 7TH ST NW APT 804
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3394
Practice Address - Country:US
Practice Address - Phone:202-491-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3737P1801X374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide