Provider Demographics
NPI:1962567743
Name:HOLLAND, CYNTHIA ANN (RN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9226 CRAIG AVE.
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-3012
Mailing Address - Country:US
Mailing Address - Phone:703-799-2923
Mailing Address - Fax:
Practice Address - Street 1:9501 FARRELL RD.
Practice Address - Street 2:
Practice Address - City:FT. BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5901
Practice Address - Country:US
Practice Address - Phone:703-805-0295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001098003163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse