Provider Demographics
NPI:1487668976
Name:MACKENNA, HOLLY VIRGINIA (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:VIRGINIA
Last Name:MACKENNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-0640
Mailing Address - Country:US
Mailing Address - Phone:252-536-5844
Mailing Address - Fax:252-519-0154
Practice Address - Street 1:2066 NC HIGHWAY 125
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-9436
Practice Address - Country:US
Practice Address - Phone:252-536-5000
Practice Address - Fax:252-536-2258
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS192392084P0800X
LA0253582084P0800X
NC2025-026672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry