Provider Demographics
NPI:1316668452
Name:HOLDGATE, HOLLY P
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:P
Last Name:HOLDGATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 PENNIMAN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-7099
Mailing Address - Country:US
Mailing Address - Phone:781-635-5024
Mailing Address - Fax:
Practice Address - Street 1:127 JOHNNY CAKE HILL RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5674
Practice Address - Country:US
Practice Address - Phone:401-846-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN68378163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIRN68378OtherRN