Provider Demographics
NPI:1962765164
Name:HOLDERFIELD, DEBORAH (CRNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:HOLDERFIELD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 JAMES PAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-8047
Mailing Address - Country:US
Mailing Address - Phone:256-249-0028
Mailing Address - Fax:256-249-0019
Practice Address - Street 1:291 JAMES PAYTON BLVD
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-8047
Practice Address - Country:US
Practice Address - Phone:256-249-0028
Practice Address - Fax:265-249-0019
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-113630363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-113630OtherCRNP COLLABORATION LICENSE
AL3687OtherPRESCRIBING NUMBER
A0512010OtherAANP CERTIFICATION