Provider Demographics
NPI:1982322244
Name:HOLLAND CASSIDY, VICTORIA LYNNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LYNNE
Last Name:HOLLAND CASSIDY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:VICTORIA
Other - Middle Name:LYNNE
Other - Last Name:CASSIDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:4 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1801
Mailing Address - Country:US
Mailing Address - Phone:978-778-8257
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2295803363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care