Provider Demographics
NPI:1932931516
Name:HOLLOWAY, KEIMISHIA TERNACE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KEIMISHIA
Middle Name:TERNACE
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 COMMONWEALTH PL # 200-1020
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4517
Mailing Address - Country:US
Mailing Address - Phone:757-749-8507
Mailing Address - Fax:
Practice Address - Street 1:900 COMMONWEALTH PL # 200-1020
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4517
Practice Address - Country:US
Practice Address - Phone:757-752-8478
Practice Address - Fax:757-330-0797
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024190985363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health