Provider Demographics
NPI:1932855244
Name:HOLLOWAY, HEATHER LEIGH (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEIGH
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:PONTOTOC
Mailing Address - State:MS
Mailing Address - Zip Code:38863-1310
Mailing Address - Country:US
Mailing Address - Phone:662-801-2826
Mailing Address - Fax:662-801-2826
Practice Address - Street 1:280 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863-1310
Practice Address - Country:US
Practice Address - Phone:662-801-2826
Practice Address - Fax:662-356-1711
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily