Provider Demographics
NPI:1427474758
Name:HOLLIDAY, NANCY
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:HOLLIDAY
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 1:27 SCHROEDER LN
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3832
Mailing Address - Country:US
Mailing Address - Phone:631-730-5766
Mailing Address - Fax:
Practice Address - Street 1:27 SCHROEDER LN
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3832
Practice Address - Country:US
Practice Address - Phone:631-730-5766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY483657-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse